Individual
KELLY GAYTAN RUIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3101 MASON MEADOWS DR NE, RIO RANCHO, NM 87144-7581
(505) 692-8420
Mailing address
3101 MASON MEADOWS DR NE, RIO RANCHO, NM 87144-7581
(505) 692-8420
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/04/2024
Last updated
12/04/2024
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