| Mary M Cline | |
|
33 Vista De Oro Placitas NM 87043-9227 | |
| (505) 697-1717 | |
| Not Available |
| Full Name | Mary M Cline |
|---|---|
| Speciality | Counselor - Professional |
| Location | 33 Vista De Oro, Placitas, New Mexico |
| Authorized Official Name and Position | Mary M Cline (OWNER, AUTHORIZED AGENT) |
| Authorized Official Contact | 5056971717 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary M Cline 33 Vista De Oro Placitas NM 87043-9227 Ph: (505) 697-1717 | Mary M Cline 33 Vista De Oro Placitas NM 87043-9227 Ph: (505) 697-1717 |
| NPI Number | 1649704776 |
|---|---|
| Provider Enumeration Date | 04/15/2017 |
| Last Update Date | 06/18/2024 |
| Certification Date | 06/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649704776 | NPI | - | NPPES |
| 17507898 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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