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STETSON LEA BERG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LSAA

Contact information

Practice address
2600 MARBLE AVE NE, ALBUQUERQUE, NM 87106-2058
(505) 272-2479
(505) 272-9843
Mailing address
2600 MARBLE AVE NE, ALBUQUERQUE, NM 87106-2058
(505) 272-2479
(505) 272-9843

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0164591
NM
171M00000X
Case Manager/Care Coordinator
Primary
NM

Other

Enumeration date
10/02/2014
Last updated
10/07/2014
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