Individual
JALISA JOHNHAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2301 N WESTERN AVE, FARMINGTON, NM 87401-3418
(505) 374-0345
Mailing address
2301 N WESTERN AVE, FARMINGTON, NM 87401-3418
(505) 374-0345
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary
—
—
Other
Enumeration date
03/01/2023
Last updated
03/01/2023
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