Individual
EVERETT CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
45 PINSBAARI, ACOMA, NM 87034
(505) 552-6661
Mailing address
PO BOX 328, ACOMA, NM 87034-0328
(505) 552-6661
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3633
NM
Other
Enumeration date
05/26/2016
Last updated
05/26/2016
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