Organization
BONHAM & ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM D DUTREMAINE LISW, LADAC (OWNER)
(505) 564-3733
Entity
Organization
Contact information
Practice address
205 N AUBURN AVE, FARMINGTON, NM 87401-8411
(505) 564-3733
(505) 564-3788
Mailing address
205 N AUBURN AVE, FARMINGTON, NM 87401-8411
(505) 564-3733
(505) 564-3788
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0090031
NM
1041C0700X
Clinical Social Worker
Primary
I-06585
NM
Other
Enumeration date
06/25/2008
Last updated
06/25/2008
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