Individual
MAUREEN B BRICKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.C. C.
Contact information
Practice address
6612 GULTON CT NE, ALBUQUERQUE, NM 87109-4407
(505) 888-1686
(505) 888-1683
Mailing address
2826 STATE HIGHWAY 14 N, MADRID, NM 87010-9746
(215) 803-5261
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CCMH0146921
NM
101YP2500X
Professional Counselor
PC000657
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
61581569
—
NM
Enumeration date
11/10/2008
Last updated
12/30/2019
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