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1659064160
WHITNEY LAKE
TAOS, NM
NPI
1659064160
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NM C-11813)
Enumeration Date
2023-05-31
Last Update Date
2023-05-31
Business Address
WHITNEY LAKE LCSW
208 PASEO DEL PUEBLO SUR UNIT 103
TAOS, NM 87571-5931
Phone number: 575-770-7836
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Mailing Address
WHITNEY LAKE LCSW
PO BOX 164
ARROYO SECO, NM 87514-0164
Phone number: 575-770-7836
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