Provider Demographics
NPI:1942595723
Name:VAUX, MARY JAMES (MA, LMHC)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:JAMES
Last Name:VAUX
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 847
Mailing Address - Street 2:
Mailing Address - City:ROCIADA
Mailing Address - State:NM
Mailing Address - Zip Code:87742-0847
Mailing Address - Country:US
Mailing Address - Phone:505-603-2004
Mailing Address - Fax:
Practice Address - Street 1:470 NM HIGHWAY 105
Practice Address - Street 2:
Practice Address - City:ROCIADA
Practice Address - State:NM
Practice Address - Zip Code:87742-0847
Practice Address - Country:US
Practice Address - Phone:505-603-2004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0140191101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health