Individual
JUAN MENDOZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
715 E. IDAHO, LAS CRUCES, NM 88007
(575) 524-2505
Mailing address
4939 SHERWOOD DR., LAS CRUCES, NM 88012
(575) 524-2505
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
0169701
NM
Other
Enumeration date
06/19/2015
Last updated
06/19/2015
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