Individual
JADE RIVAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
CR 141 1617C PRIVATE DR 13, MEDANALES, NM 87548
(505) 901-0582
Mailing address
CR 141 1617C PRIVATE DR 13, MEDANALES, NM 87548
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/04/2021
Last updated
06/04/2021
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