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Individual

MS. KIM J HAMSTRA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA LPCC

Contact information

Practice address
413 SIPAPU ROAD, BOX 6952, TAOS, NM 87571
(505) 758-5857
(505) 758-2832
Mailing address
PO BOX 228, TAOS, NM 87571
(505) 770-0439
(505) 758-3598

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0088421
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
29550009
NM
Enumeration date
04/25/2006
Last updated
01/15/2008
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