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General NPI Number Information
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NPI Number | 1083737415
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Entity Type | Individual
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Provider Name | JANE R BUTTERWORTH LMFT
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Gender | Female
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 11/14/2011
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Provider Practice Location Address
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Address Line | 1200 WHITE SANDS BLVD 115
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City | ALAMOGORDO
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State | NM
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Zip | 88310-6774
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Country | US
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Telephone | 575-921-8453
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Fax | 888-505-1701
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Provider Business Mailing Address
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Address Line | 148 COTTONWOOD CANYON RD
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City | LA LUZ
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State | NM
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Zip | 88337-9333
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Country | US
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Telephone | 575-921-8453
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Fax | 888-505-1701
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 0114721
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License Number State | NM
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