Individual
GARY B. MARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
807 CALLE CHAMISAL, ESPANOLA, NM 87532-2976
(505) 372-4511
Mailing address
1125 10TH ST NW, ALBUQUERQUE, NM 87104-2101
(505) 322-0137
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
1025
NM
Other
Enumeration date
07/31/2023
Last updated
07/31/2023
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