Individual
BRENDA ANN TANGUMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSAA
Contact information
Practice address
630 HAINES AVE NW, ALBUQUERQUE, NM 87102-1226
(505) 268-5611
(505) 268-5736
Mailing address
630 HAINES AVE NW, ALBUQUERQUE, NM 87102-1226
(505) 268-5611
(505) 268-5736
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CSA0214911
NM
Other
Enumeration date
01/13/2021
Last updated
01/13/2021
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