Individual
MS. COURTNEY MARIE CARILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SUBSTANCE ABUSE ASSO
Contact information
Practice address
3200 32ND STREET BYP, SILVER CITY, NM 88061-7802
(575) 597-2650
(575) 597-2651
Mailing address
13 MEADOW HAWK LN, SILVER CITY, NM 88022-9727
(575) 313-6714
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CTB-2022-0236
NM
Other
Enumeration date
08/23/2022
Last updated
08/23/2022
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