Individual
DIANNA VIRGINIA JARAMILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPSW
Contact information
Practice address
199 HIGHWAY 50, PECOS, NM 87552-0710
(505) 757-7139
(505) 757-2700
Mailing address
PO BOX 710, PECOS, NM 87552-0710
(505) 757-7139
(505) 757-2700
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
603
NM
Other
Enumeration date
12/20/2018
Last updated
12/20/2018
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