Individual
MRS. MARQUITA D EARLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADAC
Contact information
Practice address
1615 OJO CT., FARMINGTON, NM 87401-5442
(505) 564-4804
Mailing address
1615 OJO CT., FARMINGTON, NM 87401-5442
(505) 564-4804
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
4348
NM
Other
Enumeration date
11/04/2010
Last updated
02/06/2012
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