Individual
ESTILLA LIGHTFOOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
2960 RODEO PARK DRIVE WEST, SANTA FE, NM 87505
(505) 946-1459
Mailing address
2 GEOFFRY CT, SANDIA PARK, NM 87047
(505) 681-5725
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
M-08067
NM
Other
Enumeration date
09/07/2012
Last updated
09/07/2012
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