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Individual

MIRTHA DIBELY ACOSTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMHC

Contact information

Practice address
803 TIJERAS AVE NW, ALBUQUERQUE, NM 87102-3096
(505) 243-2223
(505) 243-3576
Mailing address
PO BOX 7065, ALBUQUERQUE, NM 87194-7065
(505) 243-2223
(505) 243-3576

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0173241
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
87177056
NM
Enumeration date
04/11/2015
Last updated
04/11/2015
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