Individual
MRS. WANDA MAE WESTBROOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NMLADAC
Contact information
Practice address
HWY 491 N, PINON STREET, SHIPROCK, NM 87420
(505) 368-1069
(505) 368-1055
Mailing address
PO BOX 1830, SHIPROCK, NM 87420-1830
(505) 368-1050
(505) 368-1055
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
4046
NM
Other
Enumeration date
05/17/2007
Last updated
07/09/2019
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