Individual
JASON L FERRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADAC
Contact information
Practice address
195 JUNIPER RD, RUIDOSO, NM 88345-6636
(817) 243-6468
Mailing address
195 JUNIPER RD, RUIDOSO, NM 88345-6636
(817) 243-6468
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
13580
TX
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CAD0208871
NM
Other
Enumeration date
04/09/2020
Last updated
04/09/2020
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