Organization
LARRY RAYBURN PSYCHOTHERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY RAYBURN LPCC (OWNER)
(505) 310-5698
Entity
Organization
Contact information
Practice address
1503 LLANO ST STE A, SANTA FE, NM 87505-2000
(505) 310-5698
Mailing address
1411 SANTA CRUZ DR, SANTA FE, NM 87505-3861
(505) 310-5698
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
0100911
NM
Other
Enumeration date
05/22/2017
Last updated
05/22/2017
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