JERRALD TOM JAMES

FARMINGTON, NM
NPI1265077275
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NM  CAD0205831)
Enumeration Date2019-11-13
Last Update Date2019-11-13
Business Address
Mr. JERRALD TOM JAMES LADAC, LMSW
475 E 20TH ST STE D
FARMINGTON, NM 87401-2132
Phone number: 505-327-0293
Mailing Address
Mr. JERRALD TOM JAMES LADAC, LMSW
475 E 20TH ST STE D
FARMINGTON, NM 87401-2132
Phone number: 505-327-0293
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