Individual
MS. MALLORY HELEN BURNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A. LPCC
Contact information
Practice address
2469 CORRALES ROAD N.W., CORRALES, NM 87048-7530
(505) 717-9552
(505) 369-1121
Mailing address
47 DESERT WILLOW RD, CORRALES, NM 87048-7530
(505) 717-9552
(505) 369-1121
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPCC0150041
NM
101YM0800X
Mental Health Counselor
T-0127561
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
76288251
—
NM
Enumeration date
12/02/2009
Last updated
03/19/2014
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