Individual
TRACY ANN BLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSAA
Contact information
Practice address
805 TIJERAS AVE NW, ALBUQUERQUE, NM 87102-3099
(505) 242-1010
(505) 242-1551
Mailing address
805 TIJERAS AVE NW, ALBUQUERQUE, NM 87102-3099
(505) 242-1010
(505) 242-1551
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0148371
NM
Other
Enumeration date
04/03/2014
Last updated
04/03/2014
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