Individual
MELANIE J LUCERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
415 PARK ST, SOCORRO, NM 87801-4543
(575) 838-7614
(575) 838-0508
Mailing address
128 STALLION CIR, SOCORRO, NM 87801-4454
(575) 418-1094
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42721733
—
NM
Enumeration date
01/29/2018
Last updated
11/25/2024
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