Individual
MS. TAMMY R LUCERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSAA
Contact information
Practice address
835 SPRUCE ST, ESPANOLA, NM 87532-3455
(505) 747-7400
(505) 443-8310
Mailing address
835 SPRUCE ST, ESPANOLA, NM 87532-3455
(505) 747-7400
(505) 443-8310
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CTB-2024-0681
NM
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
11/27/2018
Last updated
04/23/2026
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