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Individual

ANDREW J CHIARALUCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMHC

Contact information

Practice address
412 SIPAPU ST, TAOS, NM 87571-6498
(575) 770-9513
Mailing address
412 SIPAPU ST, TAOS, NM 87571-6498
(575) 425-3274

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CHM0204511
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
73725773
NM
Enumeration date
06/03/2019
Last updated
11/19/2021
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