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Individual

HEIDI ELIZABETH WAHL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
411 S 3RD ST, RATON, NM 87740-4005
(575) 733-0003
Mailing address
PO BOX 94508, ALBUQUERQUE, NM 87199-4508
(505) 384-7352

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0188881
NM
171M00000X
Case Manager/Care Coordinator

Other

Enumeration date
09/08/2009
Last updated
11/05/2019
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