Individual
CAMILLE CISNEROZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH D
Contact information
Practice address
15885 S HIGHWAY 28, LA MESA, NM 88044-9406
(575) 202-1394
Mailing address
15885 S HIGHWAY 28, LA MESA, NM 88044-9406
(575) 202-1394
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0187171
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
54035376
—
NM
Enumeration date
02/25/2012
Last updated
01/13/2025
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