Individual
EDGAR AJANY ALONSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
400 GOLD AVE SW, ALBUQUERQUE, NM 87102-3283
(505) 224-9124
Mailing address
13232 SILVER PEAK PL NE, ALBUQUERQUE, NM 87111-8261
(757) 272-4149
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CTB-2024-0549
NM
Other
Enumeration date
07/29/2024
Last updated
07/29/2024
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