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Individual

LARISSA RAE NAVARRO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2701 W PICACHO AVE, LAS CRUCES, NM 88007-4775
(575) 652-3646
Mailing address
2701 W PICACHO AVE, LAS CRUCES, NM 88007-4775

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
81-0920531
NM
Enumeration date
01/11/2018
Last updated
01/11/2018
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