| Patrick Ercolino, | |
|
405 N Date St, T Or C, NM 87901-2377 | |
| (575) 894-7459 | |
| Not Available |
| Full Name | Patrick Ercolino |
|---|---|
| Gender | Male |
| Speciality | Counselor - School |
| Location | 405 N Date St, T Or C, New Mexico |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730634056 | NPI | - | NPPES |
| 268273 | Other | NM | STATE OF NEW MEXICO PED |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YS0200X | Counselor - School | 268273 (New Mexico) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Patrick Ercolino, 405 N Date St, T Or C, NM 87901-2377 Ph: (575) 894-7459 | Patrick Ercolino, 405 N Date St, T Or C, NM 87901-2377 Ph: (575) 894-7459 |
Carol Renninger, LISW Counselor Medicare: Not Enrolled in Medicare Practice Location: 1960 N Date St, T Or C, NM 87901 Phone: 505-267-3088 Fax: 505-267-1747 | |
Jim Vigil, Counselor Medicare: Not Enrolled in Medicare Practice Location: 405 N Date St, T Or C, NM 87901 Phone: 575-894-7459 | |
Joi Holsapple, Counselor Medicare: Not Enrolled in Medicare Practice Location: 405 N Date St, T Or C, NM 87901 Phone: 575-894-7589 |