Individual
BIANCA ROSALIA MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSAA
Contact information
Practice address
607 E APACHE ST, FARMINGTON, NM 87401-6925
(505) 326-2012
Mailing address
1429 YORK AVE, FARMINGTON, NM 87401-6790
(505) 716-7967
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CTB-2024-0631
NM
Other
Enumeration date
11/13/2024
Last updated
11/19/2024
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