Individual
LAETITIA MARIE LUCERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17C LOMAS DE LA CRUZ, ESPANOLA, NM 87532-9048
(505) 929-4848
Mailing address
PO BOX 3994, ESPANOLA, NM 87533-3994
(505) 929-4848
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
NM
Other
Enumeration date
07/16/2020
Last updated
12/07/2020
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