Individual
CHANTELLE TRISTA YAZZIE-MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
505 S MAIN ST STE 249, LAS CRUCES, NM 88001-1243
(575) 527-5823
(575) 527-5886
Mailing address
505 S MAIN ST STE 249, LAS CRUCES, NM 88001-1243
(575) 527-5823
(575) 527-5886
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SWB-2022-0951
NM
1041S0200X
School Social Worker
M-09646
NM
Other
Enumeration date
11/02/2017
Last updated
12/14/2023
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