Individual
COURTNEY KILLS IN SIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
1001 W BROADWAY, FARMINGTON, NM 87401-5638
(505) 325-0238
Mailing address
1101 W OAK ST APT A, BLOOMFIELD, NM 87413-5716
(505) 860-7774
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
X-10837
NM
104100000X
Social Worker
X-10837
NM
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Y03950402
—
KY
Enumeration date
05/08/2017
Last updated
12/02/2019
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