Individual
ELIZABETH TERRILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
213 W MESA AVE, GALLUP, NM 87301-6335
(505) 862-9776
Mailing address
213 W MESA AVE, GALLUP, NM 87301-6335
(505) 862-9776
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0171081
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07322534
—
NM
05
—
67224857
—
NM
Enumeration date
03/23/2010
Last updated
04/03/2015
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