Individual
MISTY MIERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
475 E 20TH ST STE D, FARMINGTON, NM 87401-2151
(505) 327-0293
Mailing address
475 E 20TH ST STE D, FARMINGTON, NM 87401-2151
(505) 327-0293
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CTB-2023-0142
NM
Other
Enumeration date
02/14/2023
Last updated
02/14/2023
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