Individual
MARY WILKE-GARCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
707 BROADWAY BLVD NE, ALBUQUERQUE, NM 87102-2360
(505) 342-5954
Mailing address
707 BROADWAY BLVD NE, ALBUQUERQUE, NM 87102-2360
(505) 342-5954
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2765
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09274260
—
NM
Enumeration date
04/07/2016
Last updated
02/09/2018
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