Individual
MELISSA ANN TARAZON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADAC
Contact information
Practice address
1200 W APACHE ST, FARMINGTON, NM 87401-3886
(505) 258-2763
(505) 675-2803
Mailing address
1200 W APACHE ST, FARMINGTON, NM 87401-3886
(505) 258-2763
(505) 675-2803
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0170431
NM
Other
Enumeration date
11/16/2012
Last updated
11/01/2023
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