Individual
BOBBI JEAN FRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MC,LADAC
Contact information
Practice address
750 MORRIS RD SE, LOS LUNAS, NM 87031-5242
(505) 866-2318
(505) 869-4881
Mailing address
2551 COORS BLVD NW, ALBUQUERQUE, NM 87120-1213
(505) 869-4881
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3699
NM
101YM0800X
Mental Health Counselor
3699
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3699
LICENSE
NM
Enumeration date
10/16/2006
Last updated
01/13/2015
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