Individual
GWENDOLYN MINTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSAI
Contact information
Practice address
700 FRIEDMAN AVE, LAS VEGAS, NM 87701-4231
(505) 454-5100
Mailing address
700 FRIEDMAN AVE, LAS VEGAS, NM 87701-4231
(505) 454-5100
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
4460
NM
Other
Enumeration date
03/05/2007
Last updated
07/08/2007
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