Individual
GABRIELA BACA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 S AVENUE K, STATION 3, SHROC, PORTALES, NM 88130
(505) 927-8228
Mailing address
1500 S AVENUE K, PORTALES, NM 88130-7400
(505) 927-8228
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/08/2021
Last updated
09/08/2021
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