Individual
JACKELINE JAZIEL DE ANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2960 ONATE RD, LAS CRUCES, NM 88007-8120
(575) 214-4017
Mailing address
2960 ONATE RD, LAS CRUCES, NM 88007-8120
(575) 214-4017
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/22/2025
Last updated
09/22/2025
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