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Behavioral Analyst

Espanola, New Mexico

Provider NPI: 1881928133

Provider Information:
Gender: F
Not Sole Proprietor

Practice Location:
Tel: 505-753-4123  Fax: 505-753-6947

Business Mailing Address:
Tel: --  Fax: --

Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number

Other Provider Identifiers:

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin


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