Individual
EVA E VITAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
2504 CAMINO ENTRADA, SANTA FE, NM 87507-4851
(505) 216-2727
Mailing address
2504 CAMINO ENTRADA, SANTA FE, NM 87507-4851
(505) 216-2727
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1922233402
NM
101YP2500X
Professional Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47043
—
NM
Enumeration date
05/27/2009
Last updated
01/09/2025
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