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Individual
JULIO C LANDERO
Active
Individual
JULIO C LANDERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LISAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1697
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0189
DOT/SAP
AZ
01
—
1697
LISAC
AZ
01
—
20715
ICADC
AZ
Enumeration date
02/02/2008
Last updated
02/02/2008
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