Individual
CLAY DAVID ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
1001 W BROADWAY, FARMINGTON, NM 87401-5638
(505) 325-0238
Mailing address
4724 SUNDOWN RD, FARMINGTON, NM 87401-8609
(406) 262-4578
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
T-0182251
NM
101YP2500X
Professional Counselor
Primary
CCMH0203221
NM
Other
Enumeration date
09/21/2016
Last updated
05/29/2019
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