Individual
NECIA MIMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1701 PEACH ST APT A, LOS ALAMOS, NM 87544-3053
(912) 250-6224
Mailing address
1701 PEACH ST APT A, LOS ALAMOS, NM 87544-3053
(912) 250-6224
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/29/2025
Last updated
10/09/2025
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