Individual
MELISSA MARIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6601 VALENTINE WAY, SANTA FE, NM 87507-7301
(505) 988-1951
Mailing address
408 ALTA VISTA ST, SANTA FE, NM 87505-4104
(505) 570-1841
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CTB-2023-0008
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000
NA
—
Enumeration date
01/25/2023
Last updated
01/25/2023
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