Individual
MARK GERAGHTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
650 VANDEN BOSCH PKWY, GALLUP, NM 87301-5508
(505) 726-6910
Mailing address
1901 REDROCK DR, GALLUP, NM 87301-5683
(505) 863-7000
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0085771
NM
Other
Enumeration date
09/28/2007
Last updated
09/28/2007
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