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Individual

MANASSEH CODY BEGAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
5101 COLLEGE BLVD, FARMINGTON, NM 87402-4709
(505) 787-2518
Mailing address
2529 RIO VISTA WAY, FARMINGTON, NM 87401-4562
(505) 608-4107

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CAD0195421
NM
1041C0700X
Clinical Social Worker
Primary
X11280
NM

Other

Enumeration date
08/31/2020
Last updated
08/31/2020
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