Individual
ANGELA V. CORDOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSAA
Contact information
Practice address
3204 SHERIDAN ST, CLOVIS, NM 88101-5131
(575) 219-7262
Mailing address
3204 SHERIDAN ST, CLOVIS, NM 88101-5131
(575) 219-7262
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CTB-2025-0248
NM
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CTB-2025-0248
NM
Other
Enumeration date
08/14/2025
Last updated
08/14/2025
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