Individual
YVONNE M MANDAGARAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPPC
Contact information
Practice address
HC 62 BOX 2909, THOREAU, NM 87323-9505
(505) 240-1290
Mailing address
HC 62 BOX 2909, THOREAU, NM 87323-9505
(505) 240-1290
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0126051
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
435
—
NM
Enumeration date
08/08/2010
Last updated
08/08/2010
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