Individual
ROSE CARYL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSAA
Contact information
Practice address
653 W ARRINGTON ST, FARMINGTON, NM 87401-8513
(505) 564-3733
Mailing address
653 W ARRINGTON ST, FARMINGTON, NM 87401-8513
(505) 564-3733
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CTB20230549
NM
101YA0400X
Addiction (Substance Use Disorder) Counselor
CSA0200481
NM
172V00000X
Community Health Worker
02122019
NM
Other
Enumeration date
01/18/2019
Last updated
07/23/2025
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