Provider Demographics
NPI:1619151651
Name:ARAGON, ROSI (LADAC, CCS)
Entity Type:Individual
Prefix:MS
First Name:ROSI
Middle Name:
Last Name:ARAGON
Suffix:
Gender:F
Credentials:LADAC, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3368
Mailing Address - Street 2:I-40, 26 MI. W. OF ABQ, EXIT 131, 3 MI. N, TBHS BUILDIN
Mailing Address - City:TOHAJIILEE
Mailing Address - State:NM
Mailing Address - Zip Code:87026-3368
Mailing Address - Country:US
Mailing Address - Phone:505-833-1571
Mailing Address - Fax:505-833-1572
Practice Address - Street 1:TBHS BUILDING
Practice Address - Street 2:I-40, 26 MI. W. OF ABQ, EXIT 131, 3 MI. N.
Practice Address - City:TO'HAJIILEE
Practice Address - State:NM
Practice Address - Zip Code:87026
Practice Address - Country:US
Practice Address - Phone:505-833-1571
Practice Address - Fax:505-833-1572
Is Sole Proprietor?:No
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3632101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)