Individual
MS. SUSAN LARAINE CHAMBLISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2360 INDIAN WELLS RD, ALAMOGORDO, NM 88310-4609
(575) 437-7404
Mailing address
214 ASCOT PARADE, ALAMOGORDO, NM 88310-7847
(575) 825-1183
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
C-09921
NM
1041C0700X
Clinical Social Worker
Primary
C-09921
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
91978831
—
NM
Enumeration date
07/12/2007
Last updated
01/16/2024
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