Individual
BARBARA WISTED WISTED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
70 PRINCIPE DE PAZ, SANTA FE, NM 87508-9107
(562) 477-7069
Mailing address
70 PRINCIPE DE PAZ, SANTA FE, NM 87508-9107
(562) 477-7069
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
0099151
NM
Other
Enumeration date
08/28/2018
Last updated
08/28/2018
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