Individual
MAIRA A GAYTAN ORTEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
222 SWANNACK RD, VADO, NM 88072
(575) 650-0270
Mailing address
PO BOX 13463, LAS CRUCES, NM 88013-3463
(575) 650-0270
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/21/2018
Last updated
11/21/2018
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