Individual
JONATHAN UMAMAHESWARAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 OLD LINCOLN RD, RUIDOSO, NM 88345-7839
(575) 921-3794
Mailing address
101 OLD LINCOLN RD, RUIDOSO, NM 88345-7839
(575) 921-3794
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/17/2020
Last updated
06/17/2020
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