Individual
JUDY L. MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPCC
Contact information
Practice address
921 E 21ST ST, SUITE D, CLOVIS, NM 88101-4443
(505) 762-0212
(505) 762-0660
Mailing address
921 E 21ST ST, SUITE D, CLOVIS, NM 88101-4443
(505) 762-0212
(505) 762-0660
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2577
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
70173737
—
NM
01
—
NM01R63F
BLUE CROSS BLUE SHIELD
NM
Enumeration date
10/23/2006
Last updated
07/09/2007
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