Individual
EBONY S SUAZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1120 2ND ST NW, ALBUQUERQUE, NM 87102-2218
(505) 273-8750
Mailing address
1120 2ND ST NW, ALBUQUERQUE, NM 87102-2218
(505) 273-8750
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
NM
Other
Enumeration date
08/08/2022
Last updated
01/08/2025
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