Individual
HEIDI JO EYNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
1213 DON GASPAR AVE, SANTA FE, NM 87505-0625
(505) 577-1025
Mailing address
PO BOX 22092, SANTA FE, NM 87502-2092
(505) 577-1025
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0114111
NM
103T00000X
Psychologist
LCP 330
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
54580781
—
NM
Enumeration date
12/07/2006
Last updated
02/28/2011
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