Individual
PHYLISS MAYFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
220 4TH AVE, RATON, NM 87740-2643
(575) 445-2754
Mailing address
413 SIPAPU ST, TAOS, NM 87571-6489
(575) 758-5857
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1986
NM
Other
Enumeration date
07/29/2011
Last updated
07/29/2011
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