Individual
MEGHAN MANZANARES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
602 WILLOW DR, ROSWELL, NM 88203-1268
(575) 420-1763
Mailing address
602 WILLOW DR, ROSWELL, NM 88203-1268
(575) 420-1763
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
101563693
NM
Other
Enumeration date
10/24/2016
Last updated
10/24/2016
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