Individual
JAMES HERMAN WIDNER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADAC, CADAC
Contact information
Practice address
912 1ST ST NW, ALBUQUERQUE, NM 87102-2355
(505) 224-9777
(505) 224-9779
Mailing address
912 1ST ST NW, ALBUQUERQUE, NM 87102-2355
(505) 224-9777
(505) 224-9779
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0133671
NM
Other
Enumeration date
07/09/2012
Last updated
07/09/2012
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