Individual
JALEESA O'BANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 N WHITE SANDS BLVD STE 115, ALAMOGORDO, NM 88310-6774
(866) 273-2451
Mailing address
1200 N WHITE SANDS BLVD STE 115, ALAMOGORDO, NM 88310-6774
(866) 273-2451
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SWB-2026-0727
NM
106S00000X
Behavior Technician
—
—
Other
Enumeration date
09/29/2022
Last updated
06/12/2026
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