STEPHEN CHRISTPHER MACK

TAOS, NM
NPI1871545103
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NM  005761)
Enumeration Date2006-05-16
Last Update Date2015-03-19
Business Address
Mr. STEPHEN CHRISTPHER MACK LSAA
413 SIPAPU RD
TAOS, NM 87571
Phone number: 505-758-5857
Mailing Address
Mr. STEPHEN CHRISTPHER MACK LSAA
7320 NDCBU
TAOS, NM 87571
Phone number: 505-751-4536
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