Individual
JEWELL CODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADAC
Contact information
Practice address
72 GAIL HARRIS ST, ROSWELL, NM 88203-8116
(575) 347-3400
Mailing address
28 W MARTIN ST, ROSWELL, NM 88203-8451
(907) 416-8571
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CTB-2025-0376
NM
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
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—
Other
Enumeration date
05/30/2019
Last updated
02/11/2026
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