Individual
TERESA MARQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
700 E ROOSEVELT AVE, SUITE 415, GRANTS, NM 87020-2220
(505) 876-1890
Mailing address
PO BOX 28220, SANTA FE, NM 87592-8220
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/08/2012
Last updated
11/08/2012
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