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Individual

PETER PAUL PECOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LADC

Contact information

Practice address
110 SHEEP SPRINGS WAY, JEMEZ PUEBLO, NM 87024
(505) 834-7258
(505) 834-9501
Mailing address
110 SHEEP SPRINGS WAY, JEMEZ PUEBLO, NM 87024
(505) 834-7258
(505) 834-9501

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0105861
NM

Other

Enumeration date
08/01/2007
Last updated
09/28/2012
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