Individual
CATHERINE HELENE MIX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCSS WORKER
Contact information
Practice address
1424 DEBORAH RD SE STE 205, RIO RANCHO, NM 87124-6619
(505) 636-6100
Mailing address
1424 DEBORAH RD SE STE 205, RIO RANCHO, NM 87124-6619
(505) 750-4855
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
502514253
DRIVERS LICENSE
NM
Enumeration date
04/27/2021
Last updated
04/27/2021
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