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Individual

CORKY ST. JAMES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LADAC

Contact information

Practice address
3150 CARLISLE BLVD NE, 22, ALBUQUERQUE, NM 87110-1678
(505) 830-6030
(505) 830-6031
Mailing address
3150 CARLISLE BLVD. N.E., 22, ALBUQUERQUE, NM 87110-1679
(505) 830-6030
(505) 830-6031

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3888
NM

Other

Enumeration date
08/28/2012
Last updated
08/28/2012
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