Individual
KATHLEEN BENECKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
805 EARLY ST, BLDG B STE 104 D, SANTA FE, NM 87505-6516
(505) 660-5209
(505) 795-7638
Mailing address
2891 PLAZA BLANCA, SANTA FE, NM 87507-6516
(505) 660-5209
(505) 795-7638
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CCMH0080461
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
E7436
—
NM
Enumeration date
09/18/2009
Last updated
10/16/2019
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