Individual
VICTORIA A CARROCCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
65 HWY 522, EL PRADO, NM 87529
(575) 613-2712
Mailing address
PO BOX 1511, EL PRADO, NM 87529-1511
(575) 613-2712
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CCMH0215621
NM
101YM0800X
Mental Health Counselor
CMH0193781
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
73725773
—
NM
Enumeration date
08/24/2020
Last updated
08/16/2022
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