Individual
MR. MIKE JERRY TAPIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMHC
Contact information
Practice address
3505 ELDER MEADOWS DR NE, RIO RANCHO, NM 87144-0564
(505) 892-8150
Mailing address
3505 ELDER MEADOWS DR NE, RIO RANCHO, NM 87144
(505) 892-8150
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
PROVISIONAL
NM
Other
Enumeration date
07/27/2009
Last updated
07/27/2009
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