Individual
JORDANNA LEIGH GURULE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
312 N BROADWAY ST, T OR C, NM 87901-2834
(575) 740-7219
Mailing address
49 SNAKE SPRINGS RD, CABALLO, NM 87931-8004
(575) 740-7219
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/15/2024
Last updated
08/15/2024
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