Individual
MELVIN SANDOVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
51 BOSQUE RD, ALGODONES, NM 87001-8014
(505) 639-9928
Mailing address
P.O. BOX 4339, SAN FELIPE PUEBLO, NM 87001
(505) 639-9928
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/20/2017
Last updated
01/20/2017
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