Individual
MS. KAREN WILLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2915 W HISTORIC HIGHWAY 66, GALLUP, NM 87301-6812
(505) 297-3967
Mailing address
PO BOX 3741, GALLUP, NM 87305-3741
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CTB-2024-0036
NM
Other
Enumeration date
04/26/2024
Last updated
04/26/2024
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