Individual
MS. BERNICE E SICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.A.
Contact information
Practice address
303 S 1ST ST, GALLUP, NM 87301-6211
(505) 722-0641
(505) 722-9870
Mailing address
PO BOX 1437, CONNECTIONS, INC. ATTN BERNICE E. SICE, GALLUP, NM 87305-1437
(505) 722-0641
(505) 722-9870
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3986
NM
Other
Enumeration date
05/09/2007
Last updated
07/08/2007
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