Individual
MS. CHARLENE HAHTATLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.A., TLADAC
Contact information
Practice address
420 W BROADWAY, FARMINGTON, NM 87401-5908
(505) 326-9157
(505) 326-5055
Mailing address
1001 W BROADWAY, D, FARMINGTON, NM 87401-5638
(505) 326-9157
(505) 326-5055
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0067202
NM
Other
Enumeration date
06/13/2011
Last updated
06/13/2011
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