Individual
JUNIPER DECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
5201 VENICE AVE NE, ALBUQUERQUE, NM 87113-2337
(555) 555-5555
Mailing address
5201 VENICE AVE, ALBUQUERQUE, NM 87113-1213
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0165771
NM
Other
Enumeration date
02/01/2012
Last updated
04/28/2015
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