Individual
SANDRA MICHELLE SANTOS RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
5300 MCNUTT RD, SUITE 11, SANTA TERESA, NM 88008-9606
(915) 422-1968
(915) 877-5107
Mailing address
6621 DONIPHAN DR STE G, CANUTILLO, TX 79835-5005
(915) 877-5100
(915) 877-5107
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0171681
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64153274
—
NM
05
—
70336849
—
NM
Enumeration date
03/09/2011
Last updated
04/28/2017
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