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Individual

KERRY J NIEC

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPCC

Contact information

Practice address
2707 HOT SPRINGS BLVD, LAS VEGAS, NM 87701-4093
(505) 426-7847
Mailing address
PO BOX 158, EL CENTRO FAMILY HEALTH, 538 N. PASEO DE ONATE, ESPANOLA, NM 87532-0158
(505) 753-7218
(505) 753-5815

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
0196451
NM
101Y00000X
Counselor
101YM0800X
Mental Health Counselor
Primary
0160451
NM
101YM0800X
Mental Health Counselor
CCMH0196451
NM

Other

Enumeration date
12/18/2013
Last updated
08/27/2021
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