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Individual

MR. BOBBY G CANDELARIA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LADAC

Contact information

Practice address
205 N AUBURN AVE, FARMINGTON, NM 87401-8411
(505) 564-3733
Mailing address
803 W FIRWOOD ST, BLOOMFIELD, NM 87413-5020
(505) 632-8075

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0069761
NM

Other

Enumeration date
10/28/2008
Last updated
10/28/2008
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