Individual
MRS. DJ GALLEGOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
2669 SCENIC DR, 2539 MEDICAL DRIVE SUITE 106, ALAMOGORDO, NM 88310-8700
(575) 446-5300
(575) 446-5304
Mailing address
2669 SCENIC DR, 2539 MEDICAL DRIVE SUITE 106, ALAMOGORDO, NM 88310-8700
(575) 446-5300
(575) 446-5304
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
I-1561
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
I1561
LISW
NM
Enumeration date
05/19/2011
Last updated
05/19/2011
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