Individual
DUSTIN MCGOWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
4730 BECKNER ROAD, SANTA FE, NM 87507
(505) 989-4500
(505) 443-8313
Mailing address
1200 N PASEO DE ONATE, ESPANOLA, NM 87532-2687
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CMH0188251
NM
101YM0800X
Mental Health Counselor
Primary
0188251
NM
Other
Enumeration date
05/03/2017
Last updated
09/12/2023
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