Individual
MARISSA BINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
1025 HERMOSA DR SE, ALBUQUERQUE, NM 87108-4312
(505) 237-0061
(505) 237-0068
Mailing address
31 SIERRA ROSA, SANTA FE, NM 87507-7602
(541) 870-9374
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
T-0177501
NM
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
06/30/2014
Last updated
11/11/2015
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