Individual
ADAM V BACA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LPCC
Contact information
Practice address
2325 CERRILLOS RD, THE LIFE LINK, SANTA FE, NM 87505-3373
(505) 438-0010
Mailing address
PO BOX 4421, FAIRVIEW, NM 87533-4421
(505) 804-6268
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0086901
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65659058
—
NM
Enumeration date
11/02/2005
Last updated
02/12/2008
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