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Individual

CYNTHIA MCDANIEL-JOHANSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC, PHD

Contact information

Practice address
121 WYATT DR STE 7, LAS CRUCES, NM 88005-2960
(575) 526-9878
(575) 526-7835
Mailing address
146 BLACKTAIL DEER AVE, LAS CRUCES, NM 88007-5220
(575) 526-9878
(575) 526-7835

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0190391
NM
101YP2500X
Professional Counselor
63257
TX
103T00000X
Psychologist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
63257
TEXAS LPC LICENSE
TX
Enumeration date
11/05/2009
Last updated
11/29/2017
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