Individual
MS. NECIA M. ETHRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
1337 GUSDORF ROAD, SUITE E, TAOS, NM 87571
(575) 758-4297
(575) 751-7237
Mailing address
327 LA LUZ DRIVE, TAOS, NM 87571-6489
(575) 770-2137
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0159201
NM
Other
Enumeration date
09/07/2011
Last updated
06/23/2013
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