Individual
MR. CALVIN J NEZ SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LISAC, ICADC, SCB
Contact information
Practice address
BUILDING NO 25, TUBA CITY, AZ 86045
(928) 283-3031
(928) 283-3039
Mailing address
PO BOX 3685, TUBA CITY, AZ 86045-3685
(928) 283-6966
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC-11030
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
329492
—
AZ
Enumeration date
05/23/2007
Last updated
07/08/2007
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