Individual
CAROL Y GACHUPIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LDAC
Contact information
Practice address
110 SHEEP SPRINGS, JEMEZ PUEBLO, NM 87024
(505) 834-7258
Mailing address
PO BOX 451, JEMEZ PUEBLO, NM 87024
(505) 834-7746
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3782
NM
Other
Enumeration date
01/16/2007
Last updated
07/08/2007
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