Individual
KELLEY CHAVEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
1709 MOON ST NE, ALBUQUERQUE, NM 87112-3935
(505) 271-0329
Mailing address
1709 MOON ST NE, ALBUQUERQUE, NM 87112-3935
(505) 271-0329
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40351572
—
NM
Enumeration date
12/20/2013
Last updated
09/02/2014
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