Individual
PENNY S MCCALLISTER-VON BONIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
2440 LOUISIANA BLVD NE STE 300, ALBUQUERQUE, NM 87110-4394
(505) 302-1660
Mailing address
624 SOLAR RD NW, ALBUQUERQUE, NM 87107-5744
(505) 321-3362
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CCMH0212541
NM
Other
Enumeration date
07/31/2020
Last updated
07/31/2020
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