Individual
MR. ELBERT JAMES WHITEHORSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1615 OJO CT, FARMINGTON, NM 87401
(505) 564-4804
(505) 564-4857
Mailing address
PO BOX 5190, FARMINGTON, NM 87499-5190
(505) 564-4804
(505) 564-4857
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
507286887
NM
Other
Enumeration date
01/10/2011
Last updated
01/10/2011
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