Individual
CARLY BRACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
390 CALLE DE ALEGRA STE C, LAS CRUCES, NM 88005-3280
(575) 222-4588
Mailing address
3100 OAK ST, LAS CRUCES, NM 88005-3769
(575) 523-2288
(575) 523-2299
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
CTB20220194
NM
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
03/30/2016
Last updated
03/19/2026
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