Individual
MELISSA ANN SANDFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5203 JUAN TABO BLVD NE, ALBUQUERQUE, NM 87111-2683
(505) 266-6121
Mailing address
6401 ACADEMY RD NE APT 95, ALBUQUERQUE, NM 87109-3316
(505) 234-9816
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
BBH-LCPC-LIC-67160
MT
101YM0800X
Mental Health Counselor
CMH0207751
NM
Other
Enumeration date
09/09/2019
Last updated
12/06/2023
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