Individual
CORRIANNE H BRONER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
624 E MAIN ST, TUCUMCARI, NM 88401-2250
(505) 307-6476
Mailing address
PO BOX 107, TUCUMCARI, NM 88401-0107
(505) 307-6476
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
T-0122951
NM
101YP2500X
Professional Counselor
Primary
0143131
NM
Other
Enumeration date
10/07/2009
Last updated
08/18/2025
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