Individual
TERESA MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
2111 COLLEGE DR, GALLUP, NM 87301-5600
(505) 397-5172
Mailing address
2111 COLLEGE DR, GALLUP, NM 87301-5600
(505) 397-5172
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CTB-2024-0836
NM
Other
Enumeration date
12/06/2024
Last updated
12/06/2024
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