Individual
AMY H BATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
2504 CAMINO ENTRADA, SANTA FE, NM 87507-4851
(505) 471-5006
Mailing address
2504 CAMINO ENTRADA, SANTA FE, NM 87507
(505) 471-9465
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
T-0169731
NM
101YP2500X
Professional Counselor
Primary
0188671
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77833830
—
NM
Enumeration date
05/22/2014
Last updated
06/19/2017
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