Individual
DOMINIC JOHN CAGLIOSTRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, LADAC
Contact information
Practice address
146 QUINCY ST NE, ALBUQUERQUE, NM 87108-1257
(505) 550-1306
(844) 434-8055
Mailing address
146 QUINCY ST NE, ALBUQUERQUE, NM 87108-1257
(505) 550-1306
(844) 434-8055
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
C-09928
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19983085
—
NM
Enumeration date
10/01/2009
Last updated
03/01/2024
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