Individual
JEANETTA SALAZAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADAC
Contact information
Practice address
7709 REDBERRY ST NW, ALBUQUERQUE, NM 87120-5235
(575) 418-8392
Mailing address
7709 REDBERRY ST NW, ALBUQUERQUE, NM 87120-5235
(575) 418-8392
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
CAD0178381
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
92481809
—
NM
Enumeration date
07/08/2014
Last updated
04/21/2025
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