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General NPI Number Information
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NPI Number | 1477979094
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Entity Type | Individual
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Provider Name | MS. MARISSA RENEE LOVE
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Gender | Female
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Dates
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Enumeration Date | 03/06/2014
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 100 W. GRIGGS AVE.
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City | LAS CRUCES
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State | NM
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Zip | 88001
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Country | US
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Telephone | 575-647-2800
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Fax | 575-647-2898
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Provider Business Mailing Address
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Address Line | 1320 S. SOLANO
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City | LAS CRUCES
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State | NM
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Zip | 88001
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Country | US
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Telephone | 575-527-7900
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Fax | 575-571-4872
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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 | CCMH0184501
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0157361
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License Number State | NM
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