Organization
T WIARD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THEODORE JOHN WIARD LPCC (CHIEF EXECUTIVE OFFICER)
(505) 690-0126
Entity
Organization
Contact information
Practice address
125 LA POSTA RD STE B15, TAOS, NM 87571-7242
(505) 690-0126
Mailing address
POST OFFICE BOX 569, ARROYO HONDO, NM 87513
(505) 690-0126
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0109811
NM
Other
Enumeration date
09/27/2013
Last updated
06/06/2024
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