Individual
MATT CHARLES LADISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4032 CALLE DE ESTRELLAS, LAS CRUCES, NM 88012-7639
(575) 636-7881
Mailing address
4032 CALLE DE ESTRELLAS, LAS CRUCES, NM 88012-7639
(575) 636-7881
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0387
NM
Other
Enumeration date
07/16/2018
Last updated
07/16/2018
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