Donovan Lucero is a Peer Specialist based in Laguna, NM. Donovan Lucero practices in Laguna, NM. The NPI Number for Donovan Lucero is 1467094029 and holds a License No. (New Mexico).
The current practice location address for Donovan Lucero is 7 Rio San Jose Dr, Laguna, NM and can be reached out via phone at 505-552-6513.
Location: 7 Rio San Jose Dr, Laguna, NM, 87026
Provider Profile Details
NPI Number
1467094029
Provider Name
Donovan Lucero
Credential
Provider Entity Type
Individual
Gender
Male
Address
7 Rio San Jose Dr, Laguna, NM, 87026
Phone Number
505-552-6513
Fax Number
Provider Enumeration Date
10/15/2019
Last Update Date
03/10/2024
Provider's Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 125433189 | 05 | NM |
Provider Business Practice Location Address Details
Address
7 Rio San Jose Dr
City
State
Zip
87026
Phone Number
505-552-6513
Fax Number
Provider Business Mailing Address Details
Address
7 Rio San Jose Dr
City
State
Zip
87026
Phone Number
505-552-6513
Fax Number
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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