| NPI | 1669765319 |
|---|---|
| Former Legal Business Name | MARY ANN LANDRY, LLC |
| Entity Type | Organization |
| Authorized Contact | MARY ANN LANDRY Provider 505-301-3820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NM 1158) |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2011-05-26 |