Individual
JOAN MEDFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 W BROADWAY STE D, FARMINGTON, NM 87401-5638
(505) 325-0328
Mailing address
PO BOX 3239, FARMINGTON, NM 87499-3239
(505) 325-0328
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
11/24/2010
Last updated
11/24/2010
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