Individual
MS. DIANA BACA MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
1101 LOPEZ RD SW, ALBUQUERQUE, NM 87105-3954
(505) 877-7060
Mailing address
1101 LOPEZ RD SW, ALBUQUERQUE, NM 87105-3954
(505) 877-7060
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0079311
NM
Other
Enumeration date
12/03/2007
Last updated
12/03/2007
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