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Individual

MR. PATRICK HARRY STAFFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPCC

Contact information

Practice address
220 VISTA DEL REY DR, VADO, NM 88072-7236
(575) 233-3240
Mailing address
220 VISTA DEL REY DR, VADO, NM 88072-7236
(575) 233-3240

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0096381
NM
1041C0700X
Clinical Social Worker
Primary
13450
TX

Other

Enumeration date
09/17/2009
Last updated
09/17/2009
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