Individual
MR. ROY WHITEEAGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.A.D.A.C.
Contact information
Practice address
4300 SILVER AVE SE, SUITE F, ALBUQUERQUE, NM 87108-2748
(505) 255-1804
(505) 265-4446
Mailing address
4300 SILVER AVE SE, SUITE F, ALBUQUERQUE, NM 87108-2748
(505) 255-1804
(505) 265-4446
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
05998
NM
Other
Enumeration date
04/08/2014
Last updated
04/08/2014
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