Individual
DELARAM HEIDARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
300 CHAMISA VLG UNIT 268, LAS CRUCES, NM 88001-6927
(575) 652-0693
Mailing address
300 CHAMISA VLG UNIT 268, LAS CRUCES, NM 88001-6927
(575) 652-0693
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/17/2019
Last updated
04/05/2021
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