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1568551679
THEDRA LUANN MARTINEZ
TAOS, NM
NPI
1568551679
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NM 0071201)
Enumeration Date
2006-10-12
Last Update Date
2007-07-08
Business Address
-- THEDRA LUANN MARTINEZ
314 DON FERNANDO ST
TAOS, NM 87571
Phone number: 505-747-1991
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Mailing Address
-- THEDRA LUANN MARTINEZ
314 DON FERNANDO ST
TAOS, NM 87571
Phone number:
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