Individual
CATHERINE C DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPCC
Contact information
Practice address
4313 CORRALES RD, OFFICE #1, CORRALES, NM 87048
(505) 818-8759
Mailing address
1700 W ELLA DR, CORRALES, NM 87048-7241
(505) 818-8759
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
NM
101YP2500X
Professional Counselor
Primary
CCMH0164081
NM
101YP2500X
Professional Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05731003
—
NM
Enumeration date
12/09/2010
Last updated
10/24/2022
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