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Individual
ALFREDO AMADOR MENDOZA SANTIAGO
Active
Individual
ALFREDO AMADOR MENDOZA SANTIAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
QMHA, CADC-R, CRM
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-22-1786
OR
101YM0800X
Mental Health Counselor
23-QMHA-I-004017
OR
172V00000X
Community Health Worker
22-CRM-824
OR
Other
Enumeration date
02/01/2022
Last updated
01/10/2024
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