Individual
DAVID NICLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMHC
Contact information
Practice address
6611 GULTON CT NE, ALBUQUERQUE, NM 87109-4407
(505) 296-3965
Mailing address
1773 AVENIDA BONITA NW, LOS LUNAS, NM 87031-8369
(505) 340-8324
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
T-0174521
NM
Other
Enumeration date
08/17/2015
Last updated
08/17/2015
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