Individual
LIESE MEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2441 CABEZON BLVD SE, RIO RANCHO, NM 87124
(505) 717-1155
(505) 717-1473
Mailing address
2441 CABEZON BLVD SE, RIO RANCHO, NM 87124
(505) 717-1155
(505) 717-1473
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
M-08057
NM
Other
Enumeration date
11/20/2012
Last updated
12/14/2015
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