Charles L Wallace, LADAC
Charles L Wallace, LADAC is an Addiction (Substance Use Disorder) Counselor in Farmington, New Mexico. Licensed in New Mexico. Registered with an NPI since 2012.
- Licensed in
- NM
- In the registry since
- 2012
Practice location Address checks out
653 W Arrington StFarmington, NM 87401-8513
Phone: (505) 564-3733
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Specialties & licences
| Addiction (Substance Use Disorder) Counselor (primary) | Taxonomy 101YA0400X · Licence 3628 (NM) |
|---|
Record details
| NPI number | 1902140932 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | LADAC |
| Sole proprietor | No |
| NPI enumerated | November 15, 2012 |
| Last updated in NPPES | May 22, 2025 |
| Certification date | May 22, 2025 |
| Mailing address | 653 W Arrington St, Farmington, NM 87401-8513 |
Other providers in Farmington
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Shannon B Trujillo, LPCC, LADAC
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-
Laveda Tsosie, LSAA
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Anthony Patrick Velarde, LSAA
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