Individual
MANA SELAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 SAWMILL RD APT 1115, SANTA FE, NM 87505-5690
(505) 209-5467
Mailing address
2500 SAWMILL RD APT 1115, SANTA FE, NM 87505-5690
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/12/2019
Last updated
07/12/2019
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