Individual
KEDZIE BEESON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6500 AMERICAS PKWY NE APT 2006, ALBUQUERQUE, NM 87110-5374
(505) 389-9336
Mailing address
PO BOX 292, TOME, NM 87060-0292
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
SWB-2024-0804
NM
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
05/01/2023
Last updated
12/12/2024
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