Provider Demographics
NPI:1952518730
Name:TSOSIE, MARIE M (BS, LADAC)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:M
Last Name:TSOSIE
Suffix:
Gender:F
Credentials:BS, LADAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1830
Mailing Address - Street 2:NAVAJO REGIONAL BEHAVIORAL HEALTH CENTER
Mailing Address - City:SHIPROCK
Mailing Address - State:NM
Mailing Address - Zip Code:87420-1830
Mailing Address - Country:US
Mailing Address - Phone:505-368-1437
Mailing Address - Fax:505-368-1452
Practice Address - Street 1:HWY 491 N., PINON ST.
Practice Address - Street 2:
Practice Address - City:SHIPROCK
Practice Address - State:NM
Practice Address - Zip Code:87420-1830
Practice Address - Country:US
Practice Address - Phone:505-368-1437
Practice Address - Fax:505-368-1452
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0132221101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)