Individual
ELISE VALLEJOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6905 ALYSSA CT, FARMINGTON, NM 87402-5088
(505) 325-3516
Mailing address
6905 ALYSSA CT, FARMINGTON, NM 87402-5088
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/20/2020
Last updated
10/20/2020
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