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Individual

MARY DIAMOND JASEPH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMHC

Contact information

Practice address
3424 PITT ST NE, ALBUQUERQUE, NM 87111-4806
(505) 453-7019
Mailing address
3424 PITT ST NE, ALBUQUERQUE, NM 87111-4806
(505) 453-7019

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0122261
NM

Other

Enumeration date
02/09/2011
Last updated
02/09/2011
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