Individual provider · Type 1 NPI

Holly Rae, LADAC

Addiction (Substance Use Disorder) Counselor · Taos, NM

NPI number 1114165594 Active

Practice location

413 Sipapu Road
Taos, NM 87571

Call (575) 758-5857 Map

Fax (575) 758-2832

Mailing address

750 Gusdorf # 308
Taos, NM 87571

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X0065382 (NM)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1114165594

Holly Rae, LADAC's National Provider Identifier is 1114165594, issued on Jan 23, 2009. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Taos, NM. The record was last updated on Jan 23, 2009.