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Contact Information

LARISSA M CAMPOS
501 S 4TH ST
SANTA ROSA, NM88435-2417
 Phone: 575-472-0745
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Counselor

101Y00000X
Indicates primary specialty

NPI Profile & details for LARISSA M CAMPOS · (Female)

NPI # 1528370608
Status Active
Credentials
Entity Individual
Enumeration date 07/06/2010
Last updated 07/06/2010 - About 16 years ago
Sole proprietor 1 No
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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