Individual
MIDORI IZUMI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
744 W ANIMAS ST, FARMINGTON, NM 87401-5617
(505) 326-9157
Mailing address
1001 W BROADWAY, FARMINGTON, NM 87401-5638
(505) 327-9149
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
01/11/2016
Last updated
01/11/2016
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