Organization
MOSSY PINE THERAPY LLC
Active
Organization
MOSSY PINE THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FELICIA RIVERA (DIRECTOR)
(505) 429-7502
Entity
Organization
Contact information
Practice address
HC 80 BOX 246, LAS VEGAS, NM 87701-9571
(505) 429-7502
Mailing address
HC 80 BOX 246, LAS VEGAS, NM 87701-9571
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
06/06/2017
Last updated
06/06/2017
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