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Addiction Substance Use Disorder

Isleta, New Mexico

Provider NPI: 1649265711

Provider Information:
Gender: F
Not Sole Proprietor

Practice Location:
Tel: 505-869-5474  Fax: 505-869-4584

Business Mailing Address:
PO BOX 640  ISLETA, NM 87022 US
Tel: 505-869-5474  Fax: 505-869-4584

Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y101YA0400XBehavioral Health & Social Service Providers
Addiction (Substance Use Disorder)


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