Individual
MYRNA A DE SANTIAGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
113 LUNA DR, SUNLAND PARK, NM 88063-9299
(915) 892-3763
Mailing address
113 LUNA DR, SUNLAND PARK, NM 88063-9299
(915) 892-3763
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/10/2019
Last updated
01/10/2019
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