Individual
EDWARD PROCOPIO ALONZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSAA
Contact information
Practice address
2028 E AZTEC AVE, GALLUP, NM 87301-4804
(505) 413-3447
Mailing address
2028 E AZTEC AVE, GALLUP, NM 87301-4804
(505) 488-8947
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CTB-2022-0709
NM
Other
Enumeration date
03/31/2025
Last updated
03/31/2025
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