Individual
XIMENA LICANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2201 SAINT FRANCIS CT, PORTALES, NM 88130-9381
(575) 652-2743
Mailing address
2201 SAINT FRANCIS CT, PORTALES, NM 88130-9381
(575) 652-2743
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
86379
NM
374J00000X
Doula
Primary
—
—
Other
Enumeration date
09/16/2024
Last updated
02/04/2026
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