Individual
GABRIELA QUEZADA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14 ROAD 5117, BLOOMFIELD, NM 87413-9706
(505) 592-6403
Mailing address
14 ROAD 5117, BLOOMFIELD, NM 87413-9706
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/26/2021
Last updated
05/26/2021
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