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Individual

AMANDA GRACE VEGA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1850 COPPER LOOP, LAS CRUCES, NM 88005-8139
(575) 449-8159
Mailing address
2701 N 16TH ST STE 316, PHOENIX, AZ 85006-1266
(602) 650-1212

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
05/20/2021
Last updated
06/23/2021
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