Individual
ANDERSON THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
15 BEHAVIORAL HEALTH ROAD, PINE HILL, NM 87357-0004
(505) 775-3353
(505) 775-3630
Mailing address
BOX 07 BIA 140, PINE HILL, NM 87357
(505) 775-3353
(505) 775-3630
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0132611
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005587
—
NM
Enumeration date
06/16/2010
Last updated
06/16/2010
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