Individual
MS. DEBORAH ANN WIRTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS LPCC
Contact information
Practice address
1919 5TH STREET, SUITE O, SANTA FE, NM 87505
(505) 699-2176
(505) 820-9811
Mailing address
19 VISTA CHICOMA RD, SANTA FE, NM 87506
(505) 820-6544
(505) 820-9811
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0185
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
N3774
—
NM
01
—
NM100139
VALUE OPTIONS
NM
Enumeration date
11/30/2006
Last updated
07/08/2007
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