Individual
PANSY WIEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
261 BOSQUE, ALAMOGORDO, NM 88310-9532
(575) 415-6293
Mailing address
261 BOSQUE, ALAMOGORDO, NM 88310-9532
(575) 415-6293
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/07/2019
Last updated
08/07/2019
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