Individual
MR. JOHN ANSELMO ESTRADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2200 GRANDE BLVD SE STE B, RIO RANCHO, NM 87124-1695
(505) 218-6383
(888) 514-6652
Mailing address
2200 GRANDE BLVD SE STE B, RIO RANCHO, NM 87124-1695
(505) 218-6383
(888) 514-6652
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/10/2024
Last updated
01/10/2024
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