Kelyn Y De Matta
Counselor in Fort. Sumner, NM. Individual provider (NPI-1).
NPI number1861784530
StatusActive
Last updated in NPPESMay 12, 2011
Details
- NPI
- 1861784530
- Entity type
- Individual (NPI-1)
- Name
- Kelyn Y De Matta
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 12, 2011
- Last updated
- May 12, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | – | – | Yes |
Practice location
678 Avenue CFort. Sumner, NM 88119
Phone 575-355-8326 · Fax 575-355-8327
Mailing address
Po Box 28220Santa Fe, NM 87592-8220
Phone 505-471-5006 · Fax 505-820-9220
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All 10 Counselor providers in Fort Sumner · All 40 providers in Fort Sumner
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