person
Mrs. Tisa Bernally-russell, BSW,LSAA
Addiction (Substance Use Disorder) Counselor in Farmington, New Mexico
NPI 1972933844

Tisa Bernally-russell is an Addiction (Substance Use Disorder) Counselor based in Farmington, NM and is specialized in Addiction (Substance Use Disorder). Tisa Bernally-russell practices in Farmington, NM and has the professional credentials of BSW,LSAA. The NPI Number for Tisa Bernally-russell is 1972933844 and holds a License No. 0160331 (New Mexico).

The current practice location address for Tisa Bernally-russell is 101 W Broadway, Farmington, NM and can be reached out via phone at 505-327-4796.

Location: 101 W Broadway, Farmington, NM, 87499-3239
person
Provider Profile Details
NPI Number
1972933844
Provider Name
Tisa Bernally-russell
Credential
BSW,LSAA
Provider Entity Type
Individual
Gender
Female
Address
101 W Broadway, Farmington, NM, 87499-3239
Phone Number
505-327-4796
Fax Number
Provider Enumeration Date
11/13/2013
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
101 W Broadway
City
State
Zip
87401-6419
Phone Number
505-327-4796
Fax Number
person
Provider Business Mailing Address Details
Address
101 W Broadway
City
State
Zip
87401-6419
Phone Number
505-327-4796
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
0160331 (New Mexico)
Definition
Definition to come...
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