Individual
GINA MARIE LETIZIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A, LMHC
Contact information
Practice address
2960 RODEO PARK DR W, SANTA FE, NM 87505-6351
(505) 986-9633
Mailing address
2504 CAMINO ENTRADA, SANTA FE, NM 87507-4851
(505) 471-5006
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0156961
NM
Other
Enumeration date
03/11/2013
Last updated
04/10/2017
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