Individual
JACQUELYN SPEAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
114 N BEHREND AVE, FARMINGTON, NM 87401-8414
(505) 326-2736
(505) 325-2127
Mailing address
114 N BEHREND AVE, FARMINGTON, NM 87401-8414
(505) 326-2736
(505) 325-2127
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0123811
NM
Other
Enumeration date
08/18/2009
Last updated
08/18/2009
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