Individual
MICHELLE CERNA JACQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13139 CENTRAL AVE NE, ALBUQUERQUE, NM 87123-3031
(505) 595-1607
Mailing address
13139 CENTRAL AVE NE, ALBUQUERQUE, NM 87123-3031
(505) 595-1607
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CTB-2022-0843
NM
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CTB-2025-0395
NM
Other
Enumeration date
03/28/2023
Last updated
12/23/2025
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