Provider Information for 1609878412
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CARRIE L WILLEY LPCC
Sex: Female
NPI: 1609878412
Last Updated: 2007-07-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1609878412 | ||||||||||||
| Enumeration Date | 2005-08-11 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | PO BOX 907 MAGDALENA, NM 87825-0907 United States Phone: 505-854-2628 | Fax:505-864-2528 | ||||||||||||
| Primary Practice Address | HWY 169 MILE POST 29 MAGDALENA, NM 87825 United States Phone: 505-854-2626 | Fax:505-854-2528 | ||||||||||||
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