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Individual

CARRIE PORTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMHC

Contact information

Practice address
4601 PARADISE BLVD NW, ALBUQUERQUE, NM 87114-6074
(505) 508-0808
(888) 896-8728
Mailing address
5721 RIO OSO DR NE, RIO RANCHO, NM 87144-4715
(505) 990-9706

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0098171
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
12231380
NM
Enumeration date
08/05/2006
Last updated
01/26/2010
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