| Doctor Name: | PEARL J. TAPAHA |
| NPI Number: | 1407220122 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LADAC |
| License Number: | 0174901 |
| Business Practice Address: | Jct Of State Hwy 371 And Navajo Rt 9 Crownpoint, NM - 873130358 |
| Business Phone Number: | 5057866232 |
| Business Fax Number: | |
| Mailing Address: | Po Box 358, CROWNPOINT |
| State: | NM |
| Postal Code: | 873130358 |
| Phone Number: | 5057866232 |
| Fax Number: | |
| NPI Enumeration Date: | 11/18/2015 |
| NPI Last Update Date: | 11/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 0174901 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |