Individual
MR. MARK ANTHONY SILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
6276 TERRELL DR, TUCUMCARI, NM 88401-9547
(505) 708-0033
Mailing address
PO BOX 833, TUCUMCARI, NM 88401-0833
(575) 708-0033
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
010371
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18851419121
—
NM
Enumeration date
03/26/2007
Last updated
11/02/2012
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