Individual
RUTH LARA WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
350 EL MOLINO BLVD, LAS CRUCES, NM 88005-2915
(575) 323-8900
(575) 267-6228
Mailing address
350 EL MOLINO BLVD, LAS CRUCES, NM 88005-2915
(575) 323-8900
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CTB-2023-0321
NM
101YP2500X
Professional Counselor
Primary
CTB-2023-0321
NM
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
92751083
—
NM
Enumeration date
04/07/2022
Last updated
05/14/2026
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