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1194932020
ROGER DANIEL MARTINEZ
TAOS, NM
NPI
1194932020
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NM 4956)
Enumeration Date
2007-05-17
Last Update Date
2007-07-08
Business Address
Mr. ROGER DANIEL MARTINEZ LADAC
413 SIPAPU
TAOS, NM 87571-6489
Phone number: 505-758-5857
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Mailing Address
Mr. ROGER DANIEL MARTINEZ LADAC
PO BOX 33073
SANTA FE, NM 87594-3073
Phone number: 505-758-7629
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