Individual
JACLYN CONGLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
801 ENCINO PL NE, ALBUQUERQUE, NM 87102-2612
(505) 272-2573
Mailing address
801 ENCINO PL NE, ALBUQUERQUE, NM 87102-2612
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
NM
Other
Enumeration date
09/27/2019
Last updated
09/27/2019
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