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Individual

TINA J JOHN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1615 OJO COURT, FARMINGTON, NM 87401
(505) 564-4804
(505) 564-4857
Mailing address
PO BOX 2622, KIRTLAND, NM 87417-2622

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0081491
NM

Other

Enumeration date
05/17/2007
Last updated
03/15/2019
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