Renita T Anderson, LADAC
Counselor, Addiction (Substance Use Disorder) in Farmington, NM. Individual provider (NPI-1).
NPI number1639703689
StatusActive
Last updated in NPPESFeb 28, 2020
Details
- NPI
- 1639703689
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Renita T Anderson
- Credential
- LADAC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 28, 2020
- Certification date
- Feb 28, 2020
- Last updated
- Feb 28, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | 3900 | NM | Yes |
Practice location
607 E Apache StFarmington, NM 87401-6925
Phone 505-326-2012 · Fax 505-215-2814
Mailing address
607 E Apache StFarmington, NM 87401-6925
Phone 505-326-2012
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