Individual
JUDITH MACDONALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
313 W APACHE ST, FARMINGTON, NM 87401-5835
(505) 325-5321
(505) 325-6453
Mailing address
313 W APACHE ST, FARMINGTON, NM 87401-5835
(505) 325-5321
(505) 325-6453
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPCC 2948
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1902014350
NPI
NM
Enumeration date
05/14/2015
Last updated
05/14/2015
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