Individual
SIERRA ROSE SANDOVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10320 COTTONWOOD PARK NW STE A, ALBUQUERQUE, NM 87114-7008
(505) 250-5204
Mailing address
10320 COTTONWOOD PARK NW STE A, ALBUQUERQUE, NM 87114-7008
(505) 250-5204
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
512442897
NM
Other
Enumeration date
05/15/2023
Last updated
05/15/2023
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