Individual
KITRINA TAMMINGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
10 ROAD 3782, FARMINGTON, NM 87401-1037
(505) 402-6886
Mailing address
10 ROAD 3782, FARMINGTON, NM 87401-1037
(505) 402-6886
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CCMH0208321
NM
103K00000X
Behavior Analyst
—
—
Other
Enumeration date
06/24/2010
Last updated
07/19/2021
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