Individual
KRISTI CODDINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
100 N CHURCH ST STE B, BLOOMFIELD, NM 87413-5754
(505) 333-7219
Mailing address
504 N CHURCH ST, BLOOMFIELD, NM 87413-5607
(505) 402-1134
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
X-11109
NM
1041C0700X
Clinical Social Worker
C-11409
NM
Other
Enumeration date
08/02/2019
Last updated
01/08/2021
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