Individual
ANTONIA LUJAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSAA
Contact information
Practice address
612 N PASEO DE ONATE, ESPANOLA, NM 87532-2963
(505) 753-2203
Mailing address
PO BOX 1656, TAOS, NM 87571-1656
(505) 779-8832
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0130781
NM
Other
Enumeration date
10/28/2011
Last updated
10/28/2011
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