Individual
MS. LISA DYKES-HARRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPCC, RPT-S
Contact information
Practice address
23 CALIENTE RD, SANTA FE, NM 87508-9166
(575) 749-3736
Mailing address
23 CALIENTE RD, SANTA FE, NM 87508-9166
(575) 749-3736
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
005790
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04850041
—
NM
05
—
91926726
—
NM
Enumeration date
08/05/2006
Last updated
01/13/2015
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