Individual
ZANE ROMANCITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADAC
Contact information
Practice address
99 D AVE, BLACK ROCK, ZUNI, NM 87327
(505) 782-4710
(505) 782-5880
Mailing address
PO BOX 339, C/O ZUNI RECOVERY CENTER, ZUNI, NM 87327-0339
(505) 782-4710
(505) 782-5880
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
005837
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
28905512
—
NM
Enumeration date
09/30/2009
Last updated
07/11/2011
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