Individual
JUDITH KAREN WILLMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
3520 ANDERSON AVE SE, ALBUQUERQUE, NM 87106-1612
(505) 340-4414
Mailing address
3520 ANDERSON AVE SE, ALBUQUERQUE, NM 87106-1612
(505) 340-4414
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
T-0103081
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
58222880
—
NM
Enumeration date
05/14/2007
Last updated
01/18/2017
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