Individual
EDWARD BACA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
700 FRIEDMAN AVE, 3695 HOT SPRINGS BLVD, LAS VEGAS, NM 87701-4231
(505) 454-5120
(505) 454-0397
Mailing address
700 FRIEDMAN AVE, 3695 HOT SPRINGS BLVD, LAS VEGAS, NM 87701-4231
(505) 454-5120
(505) 454-0397
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0149351
NM
Other
Enumeration date
04/08/2016
Last updated
04/08/2016
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