Individual
NICOLE LOERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
541 QUANTUM RD NE, RIO RANCHO, NM 87124-4502
(505) 994-9178
Mailing address
PO BOX 28220, SANTA FE, NM 87592-8220
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
M-07759
NM
Other
Enumeration date
11/19/2012
Last updated
11/19/2012
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