Individual
SKY BLUE MARIANITO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 UNIVERSITY NEW MEXICO, ALBUQUERQUE, NM 87131-0001
(505) 277-5151
Mailing address
1 UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131-0001
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/28/2023
Last updated
07/28/2023
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