Individual
SIERRA CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
51 BOSQUE RD, ALGODONES, NM 87001-8014
(505) 908-8317
Mailing address
PO BOX 604, ALGODONES, NM 87001-0604
(505) 908-8317
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
99624371
—
NM
Enumeration date
04/23/2025
Last updated
04/23/2025
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