Individual
FEHRUNISSA M WILLETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
1717 LOUISIANA BLVD NE, SUITE 102, ALBUQUERQUE, NM 87110-7001
(505) 268-1903
Mailing address
2 CABEZON RD, PLACITAS, NM 87043-9200
(505) 268-1903
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0093361
NM
Other
Enumeration date
05/31/2007
Last updated
07/08/2007
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