Individual
DR. THERESA A. KESTLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
4686 CORRALES RD, CORRALES, NM 87048-8610
(505) 898-1177
(505) 792-3551
Mailing address
PO BOX 800, CORRALES, NM 87048-0800
(505) 898-1177
(505) 792-3551
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
517
NM
Other
Enumeration date
04/03/2007
Last updated
07/08/2007
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