Individual
MRS. GISELLE DEL CARMEN BANGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
2554 SHAVANO PEAK DR NE, RIO RANCHO, NM 87144-6792
(828) 301-8171
(828) 333-5584
Mailing address
2554 SHAVANO PEAK DR NE, RIO RANCHO, NM 87144-6792
(828) 301-8171
(828) 333-5584
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CAD0212061
NM
106H00000X
Marriage & Family Therapist
1409
NC
106H00000X
Marriage & Family Therapist
Primary
CMF0201891
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6105307
—
NC
05
—
78850517
—
NM
Enumeration date
12/13/2010
Last updated
01/03/2024
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