Individual
ALVERA R UPSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADAC
Contact information
Practice address
650 VANDEN BOSCH PKWY, # B, GALLUP, NM 87301-5508
(505) 726-6900
(505) 722-6192
Mailing address
1901 REDROCK DR, PFS DEPT, GALLUP, NM 87301-5683
(505) 863-7000
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3525
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
VNM00011BLC
VALUE OPTIONS
NM
Enumeration date
03/08/2007
Last updated
07/08/2007
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