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Individual

ANDREA VILLALOBOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, LPCC

Contact information

Practice address
785 ANTHONY DRIVE, ANTHONY, NM 88021-8802
(575) 882-5100
(575) 882-1151
Mailing address
PO BOX 2671, ANTHONY, NM 88021-2671
(575) 882-5100
(575) 882-1151

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CCMH0219141
NM
101YM0800X
Mental Health Counselor
CTL0197211
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
33928037
NM
05
35650338
NM
Enumeration date
12/29/2015
Last updated
08/17/2021
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