EMILY FOSSUM

ESPANOLA, NM
NPI1528501079
Former NameEMILY MARIA RAFFEL
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YP2500X Counselor Professional
(Licence: NM  CCMH0224041)
Additional Taxonomies101YP2500X Counselor Professional
(Licence: MN  CC01318)
101YP2500X Counselor Professional
Enumeration Date2016-11-30
Last Update Date2024-04-25
Business Address
EMILY FOSSUM LPCC
835 SPRUCE ST STE C&D
ESPANOLA, NM 87532-3455
Phone number: 505-747-7400
Mailing Address
EMILY FOSSUM LPCC
835 SPRUCE ST STE C&D
ESPANOLA, NM 87532-3455
Phone number: 505-747-7400