Individual
MARYSOL GRANADOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9420 JETTY CT NW, ALBUQUERQUE, NM 87121-1975
(505) 373-6099
Mailing address
9420 JETTY CT NW, ALBUQUERQUE, NM 87121-1975
(505) 373-6099
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/25/2022
Last updated
05/25/2022
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