Individual
MRS. VANESSA DENNARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10000 COORS BYP NW STE E1, ALBUQUERQUE, NM 87114-4055
(505) 677-0988
(505) 808-4942
Mailing address
PO BOX 45281, RIO RANCHO, NM 87174-5281
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60808543
—
NM
Enumeration date
09/23/2022
Last updated
09/23/2022
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