Individual
MICAH WOLFFARTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15 OAK ST, CLAYTON, NM 88415-2530
(575) 374-8326
(575) 758-5860
Mailing address
2551 COORS BLVD NW, ALBUQUERQUE, NM 87120-1213
(575) 758-5860
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
174400000X
Specialist
—
—
Other
Enumeration date
07/31/2012
Last updated
06/13/2014
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