Individual
ADRIAN FERNANDO CORDOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2428 MORRIS ST NE, ALBUQUERQUE, NM 87112-1661
(505) 357-4853
Mailing address
2428 MORRIS ST NE, ALBUQUERQUE, NM 87112-1661
(505) 357-4853
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106S00000X
—
NM
Enumeration date
11/14/2022
Last updated
11/14/2022
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