Individual
MRS. MIRIAM JUAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
304 W GRIGGS AVE, LAS CRUCES, NM 88005-2603
(575) 405-7146
(575) 405-5446
Mailing address
304 W GRIGGS AVE STE C, LAS CRUCES, NM 88005-2603
(575) 405-7146
(575) 405-5446
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18677037
—
NM
Enumeration date
03/06/2014
Last updated
10/20/2021
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