Individual
MARILYN LANDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
301 S CAMINO DEL PUEBLO, BERNALILLO, NM 87004-6276
(505) 867-2383
(505) 867-7293
Mailing address
301 S CAMINO DEL PUEBLO, BERNALILLO, NM 87004-6276
(505) 867-2383
(505) 867-7293
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
85-0206810
—
NM
Enumeration date
05/28/2010
Last updated
04/28/2014
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