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Individual

DAVID ALLEN NATSEWAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LSAA

Contact information

Practice address
7 RIO SAN JOSE, LAGUNA, NM 87026
(505) 552-5728
Mailing address
7 RIO SAN JOSE, LAGUNA, NM 87026
(505) 552-5728

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CSA0184761
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
511708737
NM DRIVERS LICENSE
NM
Enumeration date
10/31/2019
Last updated
10/31/2019
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