Individual
ANNALICIA ORTIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
26 SALIDA DEL SOL, LOS LUNAS, NM 87031
(505) 410-0010
Mailing address
26 SALIDA DEL SOL, LOS LUNAS, NM 87031
(505) 410-0010
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
37
NM
Other
Enumeration date
09/03/2021
Last updated
09/03/2021
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