Individual
MARLENE ELAINE PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
2600 MARBLE NE, ALBUQUERQUE, NM 87131-0001
(505) 272-5109
Mailing address
6211 SUNRAY RD NW, ALBUQUERQUE, NM 87120-6141
(505) 836-1142
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0076031
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
92489362
—
NM
Enumeration date
11/14/2005
Last updated
05/04/2012
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