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General NPI Number Information
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NPI Number | 1740841022
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Entity Type | Individual
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Provider Name | VALERIE MAESTAS LMHC
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Gender | Female
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Dates
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Enumeration Date | 06/26/2019
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Last Update Date | 06/26/2019
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Provider Practice Location Address
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Address Line | 1400 S 2ND ST
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City | RATON
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State | NM
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Zip | 87740-2102
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Country | US
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Telephone | 505-398-1567
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Fax | 575-383-3337
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Provider Business Mailing Address
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Address Line | PO BOX 8
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City | RATON
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State | NM
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Zip | 87740-0008
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Country | US
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Telephone | 505-382-4922
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Fax | 575-383-3337
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | T-CTL0204921
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License Number State | NM
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