Individual
LESLIE JEAN MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
HIGHWAY 68 CR 49 PRIVATE DR. 1098, VELARDE, NM 87582
(505) 852-6170
(505) 852-1827
Mailing address
PO BOX 520, ESPANOLA, NM 87532-0520
(505) 852-6710
(505) 852-1827
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CTB-2023-0169
NM
Other
Enumeration date
07/14/2023
Last updated
07/14/2023
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