Individual
JESSICA IUDICIANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
325 N BERGIN LN, BLOOMFIELD, NM 87413-6729
(505) 632-4389
Mailing address
325 N BERGIN LN, BLOOMFIELD, NM 87413-6729
(505) 632-4389
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
Other
Enumeration date
12/01/2014
Last updated
12/01/2014
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