Individual
MS. MARY M DISSINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
101 LETTON DR, RATON, NM 87740-4366
(575) 445-8568
(575) 445-0540
Mailing address
40 MOUNTAIN MEADOW RD, CIMARRON, NM 87714-9645
(575) 445-8568
(575) 445-0540
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1495
NM
Other
Enumeration date
01/28/2008
Last updated
01/28/2008
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