Individual
SONJA R BACA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
1910 REDROCK DR, GALLUP, NM 87301-5682
(505) 863-7250
Mailing address
1901 REDROCK DR, PFS DEPT, GALLUP, NM 87301-5683
(505) 863-7000
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
485
NM
Other
Enumeration date
04/04/2007
Last updated
03/25/2015
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