Individual
DOLORES M CISNEROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2200 VENADITO TRL, ANTHONY, NM 88021-9050
(915) 820-9275
Mailing address
2200 VENADITO TRL, ANTHONY, NM 88021-9050
(915) 820-9275
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/10/2010
Last updated
11/10/2010
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