Jolly, Makayla Kristen
Jolly, Makayla Kristen is an sole proprietor health care provider with primary practice located at 1107 S Atkinson Ave , Roswell NM 88203-7154. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Jolly, Makayla Kristen can be contacted via phone (575) 578-4826.Contact Information
Primary practice address
1107 S Atkinson Ave
Roswell NM 88203-7154
Phone: (575) 578-4826
Fax: (575) 578-4828
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | CSA0217981 | New Mexico |
Profile Details
| NPI number | 1225702533 |
|---|---|
| LBN Legal business name | Jolly, Makayla Kristen |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 2nd, 2021 |
| Last updated | Aug 2nd, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1225702533 | NPPES |
| New Mexico | MEDICAID | CSA0217981 |
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