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1295784353
JONATHAN TRIMBLE MACK
ALBUQUERQUE, NM
NPI
1295784353
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: NM 0086461)
Enumeration Date
2006-05-08
Last Update Date
2010-03-08
Business Address
Mr. JONATHAN TRIMBLE MACK EdM, LPCC
7109 PROSPECT PL NE
ALBUQUERQUE, NM 87110-4313
Phone number: 505-796-4004
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Mailing Address
Mr. JONATHAN TRIMBLE MACK EdM, LPCC
PO BOX 1613
PERALTA, NM 87042-1613
Phone number: 505-796-4004
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