Most Relevant Information
Provider Data
| NPI Number: | 1003695156 |
| Provider Name: | DAMIEN DEREGO LMHC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | CTB-2023-0759 |
Most Important Dates
| Enumeration Date: | 09/27/2023 |
| Last Updated: | 09/27/2023 |
Provider Practice Location
1235 8TH ST
LAS VEGAS
NM
877014219
Practice Location Phone/Fax
| Phone: | 5054266788 |
| Fax: |
Provider Mailing Location
538 N PASEO DE ONATE
ESPANOLA
NM
875322618
Provider Mailing Phone/Fax
| Phone: | 5057537218 |
| Fax: |