Individual
HARLEY LAWSON YEAROUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSAA
Contact information
Practice address
3939 SAN PEDRO DR NE BLDG D1, ALBUQUERQUE, NM 87110-8905
(505) 217-1717
(505) 213-0041
Mailing address
9201 MONTGOMERY BLVD NE STE V, ALBUQUERQUE, NM 87111-2470
(505) 507-7984
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CTB-2023-0076
NM
Other
Enumeration date
05/30/2023
Last updated
05/30/2023
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