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DR. PETER COSBY VANLENT LSAA

Addiction (Substance Use Disorder) >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1710212006

Individual Registrant:
DR. PETER COSBY VANLENT LSAA
Gender: M
Not Sole Proprietor

Location and contact information for practice:
1 JOHN HYSON DR. BLD 4,5,6  CHIMAYO, NM 87522-0757 US
Tel: 505-351-0900  Fax: --

Contact information for business:
PO BOX 757  CHIMAYO, NM 87522-0757 US
Tel: 505-351-0900  Fax: --

Registration Information:
NPI: 1710212006
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
NM005938

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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