Individual
BERTHA YOUNGBLOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
904 E FAIRVIEW LN UNIT B, ESPANOLA, NM 87532-2806
(505) 412-5269
Mailing address
904 E FAIRVIEW LN UNIT B, ESPANOLA, NM 87532-2806
(505) 412-5269
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
NM
Other
Enumeration date
10/09/2025
Last updated
10/09/2025
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