Individual
KATHIE D MAESTAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
1100 W 21ST ST, CLOVIS, NM 88101
(575) 769-2345
(575) 769-9013
Mailing address
1100 W 21ST ST, CLOVIS, NM 88101
(575) 769-2345
(575) 769-9013
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CMH0191741
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18055869
—
NM
Enumeration date
09/05/2017
Last updated
11/10/2022
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