Individual
VICKY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
428 LOS LENTES RD, LOS LUNAS, NM 87031
(505) 366-4979
Mailing address
282 S CAMINO DEL PUEBLO STE 2C, BERNALILLO, NM 87004-5913
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/17/2014
Last updated
07/17/2014
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