Individual
MISS SANDRA MATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
507 S 4TH ST, BELEN, NM 87002-4451
(505) 361-3227
(505) 361-3227
Mailing address
507 S 4TH ST, BELEN, NM 87002-4451
(505) 361-3227
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/15/2025
Last updated
05/15/2025
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