Individual
GLORIA CHAMPION
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., LPCC
Contact information
Practice address
1601 ST. MICHAELS DRIVE, SANTA FE, NM 87505
(505) 670-0324
Mailing address
2431 VEREDA DE ENCANTO, SANTA FE, NM 87505
(505) 670-0324
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
235214
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78558
—
NM
Enumeration date
01/08/2008
Last updated
01/08/2008
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