Roger Allen Desalme Jr., LPCC
Counselor, Professional in Farmington, NM. Individual provider (NPI-1).
NPI number1174536619
StatusActive
Last updated in NPPESAug 14, 2019
Details
- NPI
- 1174536619
- Entity type
- Individual (NPI-1)
- Name
- Mr. Roger Allen Desalme Jr.
- Credential
- LPCC
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 14, 2006
- Last updated
- Aug 14, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | CCMH0205461 | NM | Yes |
| 101YP2500X | Counselor, Professional | 16736 | TX |
Practice location
1615 Ojo CourtFarmington, NM 87401
Phone 505-564-4804 · Fax 505-564-4857
Mailing address
1615 Ojo CourtFarmington, NM 87401
Phone 505-564-4804 · Fax 505-564-4857
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