Individual
MR. LUCIANO CALABAZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADAC
Contact information
Practice address
10 TESUQUE ST, SANTO DOMINGO PUEBLO, NM 87052-9998
(505) 465-2733
(505) 465-0433
Mailing address
10 TESUQUE ST, SANTO DOMINGO PUEBLO, NM 87052-9998
(505) 465-2733
(505) 465-0433
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3697
NM
Other
Enumeration date
07/18/2007
Last updated
07/18/2007
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