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Individual

MARY PATTRIDGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICSW, LADC

Contact information

Practice address
800 E 9TH AVE, TRUTH OR CONSEQUENCES, NM 87901-1961
(575) 894-2111
Mailing address
800 E 9TH AVE, TRUTH OR CONSEQUENCES, NM 87901-1961
(575) 894-2111

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
300784
MN
1041C0700X
Clinical Social Worker
17648
MN
1041C0700X
Clinical Social Worker
Primary
C-09699
NM

Other

Enumeration date
09/23/2010
Last updated
05/10/2021
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