Individual
NATHAN INTERIAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
712 SARATOGA DR NE, RIO RANCHO, NM 87124-4624
(505) 595-7093
Mailing address
1380 RIO RANCHO BLVD, #107, RIO RANCHO, NM 87124
(505) 595-7093
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CCMH0206861
NM
Other
Enumeration date
01/21/2015
Last updated
03/14/2022
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