Organization
BRYANS COUNSELING SERVICE
Active
Other names
John Bryan Stuppy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN BRYAN STUPPY LISW/LADAC (CLINICAL SOCIAL WORKE)
(505) 930-4550
Entity
Organization
Contact information
Practice address
2891 CLARK CT, SANTA FE, NM 87507-5179
(505) 930-4550
Mailing address
2891 CLARK CT, SANTA FE, NM 87507-5179
(505) 930-4550
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
I-06160
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
53052552
—
NM
Enumeration date
03/15/2011
Last updated
03/15/2011
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