Individual
MS. RENEE D LAVADIE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CASE MANAGER
Contact information
Practice address
413 SIPAPU ROAD, TAOS, NM 87571
(505) 758-5857
(505) 758-2832
Mailing address
PO BOX 366, EL PRADO, NM 87529
(505) 776-4232
(505) 776-4232
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
05/10/2006
Last updated
07/08/2007
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