Jennifer Lee Mettling

Individual provider Active NPI Marriage & Family Therapist · Edgewood, NM

NPI 1457500803 · NPPES record last updated Sep 10, 2008

Key facts

NPI
1457500803
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
Practice address
6 Patricia PL
Edgewood, NM 87015-9748
Phone
(505) 350-9342
NPI assigned
Sep 10, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Yes

Addresses

Primary practice location

6 Patricia PL
Edgewood, NM 87015-9748

Mailing address

6 Patricia PL
Edgewood, NM 87015-9748
Phone (505) 350-9342

Other providers in Edgewood, NM

All providers in Edgewood, NM · Marriage & Family Therapist in New Mexico

Sources for this page

Verify at the official NPI Registry.