Individual
LARISSA WILLSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1209 MOUNTAIN ROAD PL NE # 7464, ALBUQUERQUE, NM 87110-7845
(505) 553-9069
Mailing address
1209 MOUNTAIN ROAD PL NE # 7464, ALBUQUERQUE, NM 87110-7845
(505) 553-9069
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SWB-2022-0836
NM
Other
Enumeration date
09/20/2022
Last updated
10/22/2025
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