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Individual

VASHTI JEAN SCHWEEDLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPCC

Contact information

Practice address
1701 US RT. 66, SUITE D, MORIARTY, NM 87035
(505) 832-9135
(505) 832-9404
Mailing address
PO BOX 1978, MORIARTY, NM 87035-1978
(505) 832-9135
(505) 832-9404

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0627
NM
104100000X
Social Worker
B1708
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000B6266
NM
Enumeration date
09/20/2012
Last updated
09/20/2012
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