Individual
ANGEL R GORDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSAA
Contact information
Practice address
72 GAIL HARRIS ST, ROSWELL, NM 88203-8116
(575) 347-3400
Mailing address
3013 LA JOLLA LN, ROSWELL, NM 88201-5218
(505) 947-3666
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CSA0206891
NM
Other
Enumeration date
10/04/2019
Last updated
10/04/2019
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