Individual
MRS. ELLYN F THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADAC
Contact information
Practice address
79 CIELO AZUL RD, LOS LUNAS, NM 87031-7240
(505) 866-5439
Mailing address
79 CIELO AZUL RD, LOS LUNAS, NM 87031-7240
(505) 866-5439
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0088751
NM
Other
Enumeration date
05/21/2009
Last updated
05/21/2009
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