Individual
GRETA CARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
15 SCHOOL ROAD, PENASCO, NM 87553
(575) 587-1596
Mailing address
PO BOX 1473, RANCHOS DE TAOS, NM 87557-1473
(505) 316-6052
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
136721
NM
101YS0200X
School Counselor
304196
NM
Other
Enumeration date
06/25/2014
Last updated
09/29/2015
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