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Individual

TAI MARIE PAQUIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LADAC

Contact information

Practice address
85 WEST HWY 22, SANTO DOMINGO, NM 87052
(505) 465-3060
(505) 465-1178
Mailing address
PO BOX 123, NEW LAGUNA, NM 87038-0123
(505) 463-6152

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0153781
NM
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0188521
NM

Other

Enumeration date
03/01/2016
Last updated
02/14/2018
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