HOLLY RAE

TAOS, NM
NPI1114165594
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NM  0065382)
Enumeration Date2009-01-23
Last Update Date2009-01-23
Business Address
Ms. HOLLY RAE LADAC
413 SIPAPU ROAD
TAOS, NM 87571
Phone number: 575-758-5857
Mailing Address
Ms. HOLLY RAE LADAC
750 GUSDORF # 308
TAOS, NM 87571
Phone number: 575-758-9666
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