Individual
SANDRA WHITING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
3017 N PRINCE ST, SUITE B, CLOVIS, NM 88101-3804
(575) 562-9564
Mailing address
3017 N PRINCE ST, SUITE B, CLOVIS, NM 88101-3804
(575) 562-9564
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0175171
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
88077551
—
NM
Enumeration date
07/22/2015
Last updated
07/22/2015
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