Clear Lake Studio, LLC

NPI #1003204702 in Las Cruces, New Mexico

Provider Information

NPI Number: 1003204702
Entity Type: Organization
Organization Name: Clear Lake Studio, LLC
Primary Specialty: Counselor
Enumeration Date: Jan 3, 2015
Last Updated: Jan 3, 2015

Practice Location

Address: 1925 ANITA DR
City: Las Cruces
State: New Mexico
ZIP Code: 88001-2027
Phone: (915) 345-5489

Authorized Official

Name: MS. ANN M SKIRVIN
Title: OFFICE MANAGER
Phone: (915) 345-5489

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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