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Individual

ROSALBA I PONCE REYES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
187B SUNRISE RD, SANTA FE, NM 87507-3781
(505) 577-7685
Mailing address
187B SUNRISE RD, SANTA FE, NM 87507-3781
(505) 577-7685

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
NM

Other

Enumeration date
10/30/2019
Last updated
12/02/2019
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