Individual
RICO REYNAGA ROMERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
121 BETHEL AVE SE, ALBUQUERQUE, NM 87102-5149
(505) 355-9016
Mailing address
121 BETHEL AVE SE, ALBUQUERQUE, NM 87102-5149
(505) 355-9016
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/24/2020
Last updated
09/24/2020
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