Individual
MRS. RENITA T ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADAC
Contact information
Practice address
607 E APACHE ST, FARMINGTON, NM 87401-6925
(505) 326-2012
(505) 215-2814
Mailing address
607 E APACHE ST, FARMINGTON, NM 87401-6925
(505) 326-2012
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3900
NM
Other
Enumeration date
02/28/2020
Last updated
02/28/2020
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