Individual
MR. MATTHEW DAVID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
1807 2ND ST, SUITE 44, SANTA FE, NM 87505-3499
(505) 984-5525
Mailing address
PO BOX 207, CERRILLOS, NM 87010-0207
(505) 984-5525
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0091351
NM
Other
Enumeration date
05/28/2007
Last updated
07/08/2007
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