Individual
JEANETTE EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4950 MCNUTT RD, SANTA TERESA, NM 88063
(575) 882-6200
Mailing address
4950 MCNUTT RD, SANTA TERESA, NM 88008-9621
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
312335
NM
Other
Enumeration date
03/06/2009
Last updated
03/06/2009
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