Individual
KELLIE L HALLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BMS
Contact information
Practice address
4730 BECKNER RD, SANTA FE, NM 87507-3691
(505) 989-4500
Mailing address
4730 BECKNER RD, SANTA FE, NM 87507-3691
(505) 989-4500
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/16/2024
Last updated
12/16/2024
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