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1407979990
LAWRENCE ELDEN DETTWEILER
SANTA FE, NM
NPI
1407979990
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: NM 4706)
Enumeration Date
2007-04-09
Last Update Date
2007-07-08
Business Address
Dr. LAWRENCE ELDEN DETTWEILER Ph.D.
453 CERRILLOS RD
SANTA FE, NM 87501-3784
Phone number: 505-603-0641
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Mailing Address
Dr. LAWRENCE ELDEN DETTWEILER Ph.D.
14 MELADO DR
SANTA FE, NM 87508-2254
Phone number: 505-603-0641
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