Individual
JEANNETTE VERNA BACA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ED.D., LPCC
Contact information
Practice address
6612 GULTON CT NE, ALBUQUERQUE, NM 87109-4407
(505) 888-1686
Mailing address
16 VIA SOLE DR, ALGODONES, NM 87001-8078
(505) 573-1439
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CCMH0177521
NM
Other
Enumeration date
11/27/2019
Last updated
11/27/2019
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