Individual
ROCKY EUGENE BANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 PEACEFUL LN, CONVERSE, TX 78109-1007
(210) 248-9077
Mailing address
PO BOX 28220, SANTA FE, NM 87592-8220
(505) 471-5006
(505) 820-9220
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
09/02/2010
Last updated
02/17/2022
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