Individual
RICARDO P SPENCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADAC
Contact information
Practice address
300 W NIZHONI BLVD STE A, GALLUP, NM 87301-5766
(505) 722-9470
(505) 722-9570
Mailing address
300 W NIZHONI BLVD STE A, GALLUP, NM 87301-5766
(505) 722-9470
(505) 722-9570
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CAD3933
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
VNM00011N1
VALUE OPTIONS
NM
Enumeration date
03/08/2007
Last updated
08/22/2024
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