Individual
MARIE D RAYBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSAA
Contact information
Practice address
10203 MOUNTAIN RD NE, ALBUQUERQUE, NM 87112-5236
(505) 480-7381
Mailing address
10203 MOUNTAIN RD NE, ALBUQUERQUE, NM 87112-5236
(505) 480-7381
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CTB-2024-0098
NM
101YM0800X
Mental Health Counselor
Primary
CTB-2024-0098
NM
Other
Enumeration date
03/25/2024
Last updated
04/08/2026
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