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Individual

MRS. LOUISE L MARIANO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LADAC

Contact information

Practice address
300 W NIZHONI BLVD STE A, GALLUP, NM 87301-5766
(505) 722-9470
Mailing address
300 W NIZHONI BLVD STE A, GALLUP, NM 87301-5766
(505) 722-9470

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
08/12/2013
Last updated
03/03/2022
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