Individual
TAMMY ELIZABETH WILLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3876 HAWKINS ST NE, ALBUQUERQUE, NM 87109-4539
(505) 508-0865
Mailing address
8921 PRINCESS JEANNE AVE NE, ALBUQUERQUE, NM 87112-3939
(505) 250-3057
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/13/2019
Last updated
02/13/2019
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