Individual
JACQUELINE KAY BANEGAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1320 S SOLANO DR, LAS CRUCES, NM 88001-3758
(575) 556-1545
Mailing address
204 W ETHEL AVE, LAS CRUCES, NM 88005-1712
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/26/2011
Last updated
06/07/2013
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