Individual
ANGELICA F WHITAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
210 N AUBURN AVE, FARMINGTON, NM 87401-8412
(505) 402-6886
Mailing address
210 N AUBURN AVE, FARMINGTON, NM 87401-8412
(970) 589-0797
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CTB-2025-0602
NM
Other
Enumeration date
08/25/2025
Last updated
08/25/2025
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