Individual
MR. JOHN STAN ESPINOZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADAC
Contact information
Practice address
413 SIPAPU ROAD, TAOS, NM 87571
(505) 758-5857
Mailing address
PO BOX 1214, TAOS, NM 87571-1214
(505) 737-5533
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0073521
NM
Other
Enumeration date
09/05/2007
Last updated
09/05/2007
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