Individual
MRS. THEA CAROLYN KAVANAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4527 GALISTEO LOOP, LAS CRUCES, NM 88011-4301
(575) 635-9013
Mailing address
4527 GALISTEO LOOP, LAS CRUCES, NM 88011-4301
(575) 635-9013
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
—
—
225800000X
Recreation Therapist
Primary
—
—
Other
Enumeration date
10/10/2024
Last updated
10/10/2024
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