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Organization

DJ2 JUNCTIONS INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DELLA DAWN GARLITZ-BEDINGFIELD (CEO/PRESIDENT)
(575) 935-8522
Entity
Organization

Contact information

Practice address
1200 N THORNTON ST STE J, CLOVIS, NM 88101-5508
(575) 935-8522
Mailing address
1200 N THORNTON ST STE J, CLOVIS, NM 88101-5508
(575) 935-8522

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
0144951
NM
101YA0400X
Addiction (Substance Use Disorder) Counselor
0148831
NM
101YM0800X
Mental Health Counselor
Primary
0144951
NM
101YM0800X
Mental Health Counselor
0170731
NM
101YP2500X
Professional Counselor
0144951
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
357783771
NM
05
51206544
NM
Enumeration date
02/21/2011
Last updated
02/10/2017
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