Organization
TIME 4 CHANGE, LLC
Active
Other names
Time 4 Change Wellness Solutions
Organization subpart
No
Provider details
NPI number
Authorized official
TROY CAMPBELL LCSW (PROVIDER)
(505) 709-0608
Entity
Organization
Contact information
Practice address
19525 TOMAS LANE, ESPANOLA, NM 87532
(505) 709-0608
Mailing address
PO BOX 2212, ESPANOLA, NM 87532-2212
(505) 709-0608
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437615564
—
NM
Enumeration date
03/29/2022
Last updated
03/29/2022
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