Provider Demographics
NPI:1932412061
Name:LAWLOR, VIRGINIA MARIE (BA CPRP)
Entity Type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:MARIE
Last Name:LAWLOR
Suffix:
Gender:F
Credentials:BA CPRP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7315 GUADALUPE TRL NW
Mailing Address - Street 2:
Mailing Address - City:LOS RANCHOS
Mailing Address - State:NM
Mailing Address - Zip Code:87107-6667
Mailing Address - Country:US
Mailing Address - Phone:505-715-9287
Mailing Address - Fax:
Practice Address - Street 1:7315 GUADALUPE TRL NW
Practice Address - Street 2:
Practice Address - City:LOS RANCHOS
Practice Address - State:NM
Practice Address - Zip Code:87107-6667
Practice Address - Country:US
Practice Address - Phone:505-715-9287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-18
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor