Individual
MR. JUSTIN EVERETT WASSEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMHC
Contact information
Practice address
1218 GRIEGOS RD NW, ALBUQUERQUE, NM 87107-3752
(505) 345-8471
(505) 342-5495
Mailing address
625 FIELDSTREAM BLVD, ORLANDO, FL 32825-7209
(407) 459-2066
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0151341
NM
Other
Enumeration date
09/24/2012
Last updated
09/24/2012
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