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Individual

MS. KAYLEE BRIANA CHAVEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
01 SAGEBRUSH, ISLETA, NM 87022
(505) 869-4866
(505) 869-4881
Mailing address
P.O BOX 640, ISLETA, NM 87022-0640
(505) 869-4866
(505) 869-4881

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CSA0212871
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CSA0212871
LICENSE
NM
Enumeration date
06/16/2021
Last updated
06/16/2021
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