TISA BERNALLY-RUSSELL

FARMINGTON, NM
NPI1972933844
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NM  0160331)
Enumeration Date2013-11-13
Last Update Date2013-11-13
Business Address
Mrs. TISA BERNALLY-RUSSELL BSW, LSAA
101 W BROADWAY SUITE D
FARMINGTON, NM 87401-6419
Phone number: 505-327-4796
Mailing Address
Mrs. TISA BERNALLY-RUSSELL BSW, LSAA
PO BOX 3239 101 W. BROADWAY, SUITE D
FARMINGTON, NM 87499-3239
Phone number: 505-327-4796
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