Individual
JUAN BLEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.ED. LADAC
Contact information
Practice address
2442 CERRILLOS RD # 195, SANTA FE, NM 87505-3262
(505) 795-0588
Mailing address
2442 CERRILLOS RD # 195, SANTA FE, NM 87505-3262
(505) 795-0588
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T0126851
NM
Other
Enumeration date
11/06/2009
Last updated
11/06/2009
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