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General NPI Number Information
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NPI Number | 1396093167
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Entity Type | Individual
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Provider Name | GRETCHEN WACHS LPCC
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Gender | Female
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Dates
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Enumeration Date | 08/27/2012
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 1532 CERRILLOS RD
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City | SANTA FE
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State | NM
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Zip | 87505-3512
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Country | US
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Telephone | 505-490-5653
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Fax |
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Provider Business Mailing Address
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Address Line | P.O.611
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City | TESUQUE
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State | NM
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Zip | 87574
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Country | US
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Telephone | 505-501-0962
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0163211
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License Number State | NM
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