Individual
MR. RICK L CHURCH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
L.P.C.C.
Contact information
Practice address
1505 15TH ST, LOS ALAMOS, NM 87544-3000
(505) 662-3264
Mailing address
PO BOX 1242, ABIQUIU, NM 87510-1242
(505) 685-0547
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
84321
NM
Other
Enumeration date
06/20/2006
Last updated
07/08/2007
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