Individual
SAMANTHA L. FERNANDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
45 PINSBAARI DRIVE, PUEBLO OF ACOMA, NM 87034
(505) 552-6661
(505) 552-6427
Mailing address
45 PINSBAARI DRIVE, PUEBLO OF ACOMA, NM 87034
(505) 552-6661
(505) 552-6427
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/09/2016
Last updated
06/09/2016
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