Individual
ANNALISSA SPELLBRING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSAA
Contact information
Practice address
228 N SCHWARTZ AVE, FARMINGTON, NM 87401-5547
(505) 327-4584
Mailing address
653 W ARRINGTON ST, FARMINGTON, NM 87401-8513
(505) 564-3733
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CSA0216641
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CSA0216641
LICENSE
NM
Enumeration date
04/06/2021
Last updated
04/06/2021
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