Individual
MR. THOMAS RAMON ARCHULETA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSAA
Contact information
Practice address
1264 RODEO RD, SANTA FE, NM 87505-6816
(505) 982-2129
(505) 992-1149
Mailing address
6452 HOOCHANEETSA BLVD, COCHITI LAKE, NM 87083-6029
(505) 577-5974
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0180621
NM
Other
Enumeration date
03/05/2018
Last updated
03/05/2018
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