Individual
LADA E WOBENSMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1429 ZEPOL RD APT 106, SANTA FE, NM 87507-7137
(901) 402-6195
Mailing address
1429 ZEPOL RD APT 106, SANTA FE, NM 87507-7137
(901) 402-6195
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/21/2019
Last updated
05/21/2019
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