Individual
MISS CHEYANNE ROSE MARTINEZ QUINTANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
968 OLD LAS VEGAS HWY, SANTA FE, NM 87505-1407
(505) 901-1554
Mailing address
968 OLD LAS VEGAS HWY, SANTA FE, NM 87505-1407
(505) 901-1554
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
515184040
NM
Other
Enumeration date
03/01/2020
Last updated
03/01/2020
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