Individual
MRS. JANICE MARIE HURST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADAC
Contact information
Practice address
225 GRAND AVE, LAS VEGAS, NM 87701-3832
(505) 454-9611
Mailing address
225 GRAND AVE, LAS VEGAS, NM 87701-3832
(505) 454-9611
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3799
NM
Other
Enumeration date
04/22/2008
Last updated
04/22/2008
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