Individual
CHARLOTTE BEATY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
85 LAGARTO RD, TIJERAS, NM 87059-7454
(505) 917-2835
Mailing address
85 LAGARTO RD, TIJERAS, NM 87059-7454
(505) 917-2835
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
4016
NM
Other
Enumeration date
08/07/2015
Last updated
08/07/2015
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