Santana M Titla

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Isleta, NM

NPI 1619129509 · NPPES record last updated Oct 22, 2008

Key facts

NPI
1619129509
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
0114121 (NM)
Practice address
01 Sagebrush Street
Isleta, NM 87022-0640
Phone
(505) 869-3200
Fax
(505) 869-4584
NPI assigned
Oct 22, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0114121NMMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 0114121 NM Yes

Addresses

Primary practice location

01 Sagebrush Street
Isleta, NM 87022-0640

Mailing address

PO Box 640
Isleta, NM 87022-0640
Phone (505) 869-3200

Other providers in Isleta, NM

All providers in Isleta, NM · Addiction (Substance Use Disorder) Counselor in New Mexico

Sources for this page

Verify at the official NPI Registry.