Individual
ROSE MAESTAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSAA
Contact information
Practice address
1350 PASEO DEL PUEBLO SUR STE 7, TAOS, NM 87571-5978
(575) 737-5533
Mailing address
PO BOX 634, RANCHOS DE TAOS, NM 87557-0634
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0112171
NM
Other
Enumeration date
07/26/2010
Last updated
07/26/2010
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