Individual
CHERYL LYNN LICHTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADAC 0167681
Contact information
Practice address
715 E IDAHO AVE, STE 4B, LAS CRUCES, NM 88001-4703
(575) 524-2505
Mailing address
PO BOX 1078, LAS CRUCES, NM 88004-1078
(575) 524-2505
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LADAC 0167681
NM
Other
Enumeration date
11/04/2014
Last updated
11/04/2014
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