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Individual

ALICEMARY PELAYO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1701 S 11TH ST, TUCUMCARI, NM 88401-3715
(505) 461-4344
Mailing address
PO BOX 385, TUCUMCARI, NM 88401-0385
(505) 461-4344

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
205072
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00321729
SPECIAL ED. DIRECTOR
NM
Enumeration date
03/02/2007
Last updated
07/08/2007
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