Individual
WALDO WINBORN II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
415 W HEMLOCK ST, DEMING, NM 88030-3622
(575) 694-5478
Mailing address
415 W HEMLOCK ST, DEMING, NM 88030-3622
(575) 694-5478
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0134401
NM
101YP2500X
Professional Counselor
Primary
0134401
NM
Other
Enumeration date
09/10/2009
Last updated
09/01/2010
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