Individual
MARILYN RENEE MCKENSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
PINON & COTTIONWOOD DRIVE BUILDING 2301, SHIRPOCK, NM 87420
(505) 368-1050
Mailing address
PO BOX 1830, SHIPROCK, NM 87420-1830
(505) 368-1050
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CTB-2022-0116
NM
Other
Enumeration date
06/02/2022
Last updated
06/21/2022
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