Individual
FRANK FIDEL FRAGUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADAC
Contact information
Practice address
110 SHEEP SPRINGS, JEMEZ PUEBLO, NM 87024
(505) 834-3139
(505) 834-9507
Mailing address
PO BOX 207, JEMEZ PUEBLO, NM 87024
(505) 834-7710
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3781
NM
Other
Enumeration date
01/12/2007
Last updated
07/08/2007
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