Individual
FAE M EPALOOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
2025 E AZTEC AVE, GALLUP, NM 87301-4803
(505) 633-8288
(505) 443-4345
Mailing address
2025 E AZTEC AVE, GALLUP, NM 87301-4803
(058) 633-8285
(505) 443-4345
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CCMH0135721
NM
Other
Enumeration date
03/07/2008
Last updated
05/14/2024
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