Individual
PHILOMENA LUIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADAC
Contact information
Practice address
110 E MESCALERO RD, ROSWELL, NM 88201-6542
(575) 623-1480
(575) 622-3325
Mailing address
PO BOX 1978, ROSWELL, NM 88202-1978
(575) 623-1480
(575) 622-3325
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3573
NM
Other
Enumeration date
08/20/2009
Last updated
08/20/2009
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