Individual
MS. DIEGA CAROL MANTIONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMT
Contact information
Practice address
810 BACA ST APT F, SANTA FE, NM 87505-0950
(505) 603-4187
Mailing address
810 BACA ST APT F, SANTA FE, NM 87505-0950
(505) 603-4187
Taxonomy
Speciality
Code
Description
License number
State
225600000X
Dance Therapist
Primary
—
—
Other
Enumeration date
04/23/2013
Last updated
04/23/2013
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