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General NPI Number Information
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NPI Number | 1588591622
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Entity Type | Organization
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Legal Business Name | DESERT SANDS MENTAL HEALTH AND PLAY THERAPY LLC
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Dates
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Enumeration Date | 05/05/2026
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Last Update Date | 05/05/2026
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Provider Practice Location Address
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Address Line | 100 S AVENUE A STE B6
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City | PORTALES
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State | NM
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Zip | 88130-5917
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Country | US
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Telephone | 575-607-5588
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Fax |
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Provider Business Mailing Address
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Address Line | 130 CREST POINTE DR
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City | PORTALES
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State | NM
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Zip | 88130-9057
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Country | US
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Telephone | 575-607-5588
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | REBBECCA JO GOSSETT
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Credential |
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Telephone | 575-607-5588
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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