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Individual

MS. JESSICA LYNN CALLAWAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPCC

Contact information

Practice address
1102 A PASEO DE ONATE, ESPANOLA, NM 87532
(505) 852-1377
(505) 852-1378
Mailing address
1102 A PASEO DE ONATE, ESPANOLA, NM 87532
(505) 852-1377
(505) 852-1378

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0113441
NM
101YM0800X
Mental Health Counselor
0120981
NM
101YM0800X
Mental Health Counselor
Primary
0132841
NM

Other

Enumeration date
09/01/2009
Last updated
07/08/2010
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