Organization
LUNA Y SOL LIFE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA GRAY PLCSW (OWNER/MANAGER/PROVIDER)
(575) 626-6349
Entity
Organization
Contact information
Practice address
2001 W 4TH ST, ROSWELL, NM 88201-1752
(575) 626-6349
Mailing address
PO BOX 2773, ROSWELL, NM 88202-2773
(575) 626-6349
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245620400
—
NM
Enumeration date
07/05/2017
Last updated
07/05/2017
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