Individual
MICHELLE MARIETTE MAZULIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10700 ACADEMY RD NE APT 2022, ALBUQUERQUE, NM 87111-7337
(505) 440-8617
Mailing address
PO BOX 35905, ALBUQUERQUE, NM 87176-5905
(505) 440-8617
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/28/2018
Last updated
02/28/2018
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