Individual
MRS. LUPE E BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1043 HWY 313, BERNALILLO, NM 87004-6912
(505) 867-3351
(505) 867-3514
Mailing address
1043 HWY 313, BERNALILLO, NM 87004-6912
(505) 867-3351
(505) 867-3514
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
67352
NM
Other
Enumeration date
07/02/2008
Last updated
07/02/2008
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