Organization
REGION IX EDUCATION COOPERATIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVELYN SANCHEZ (MEDICAID SERVICES TECHNICIAN)
(505) 257-2368
Entity
Organization
Contact information
Practice address
1400 SUDDERTH DR, RUIDOSO, NM 88345-6103
(505) 257-2368
(505) 257-2141
Mailing address
1400 SUDDERTH DR, RUIDOSO, NM 88345-6103
(505) 257-2368
(505) 257-2141
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
257884
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q5515
—
NM
Enumeration date
10/20/2006
Last updated
08/22/2020
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