Individual
LUIS MANUEL CHAVESTE-FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12121 NM HIGHWAY 14, CEDAR CREST, NM 87008
(575) 202-1117
Mailing address
4600 COLUMBINE AVE NE, ALBUQUERQUE, NM 87113-2236
(505) 202-1117
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
NM
Other
Enumeration date
11/07/2023
Last updated
11/07/2023
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