Organization
A PLACE OF HEALING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY LYN TREVINO ED.S, LPCC (PROVIDER/OPERATOR)
57546449209
Entity
Organization
Contact information
Practice address
121 WYATT DR STE 5, LAS CRUCES, NM 88005-2960
(575) 644-9209
(575) 647-5050
Mailing address
5065 COMANCHE TRL, LAS CRUCES, NM 88012-7376
(575) 644-9209
(575) 647-5050
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0116921
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04932862
—
NM
01
—
1477626299
INDIVIDUAL NPI#
NM
Enumeration date
08/11/2014
Last updated
08/11/2014
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