Individual
MARY TAGISH MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1123 3RD ST SW, ALBUQUERQUE, NM 87102-4134
(505) 238-9945
Mailing address
1123 3RD ST SW, ALBUQUERQUE, NM 87102-4134
(505) 238-9945
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
—
—
Other
Enumeration date
12/13/2011
Last updated
12/13/2011
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