Organization
CHANGING LIFE'S DIRECTION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIE GINGA LPCC (OWNER/THERAPIST)
(505) 450-1948
Entity
Organization
Contact information
Practice address
4627 CORRALES RD., CORRALES, NM 87048
(505) 450-1948
Mailing address
122 ASHLEY LN, CORRALES, NM 87048-8922
(505) 450-1948
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
0083821
NM
Other
Enumeration date
08/19/2008
Last updated
08/19/2008
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