Individual
CHASITITY BEULAH NEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
37 RD 7101 #127, FARMINGTON, NM 87401
(505) 793-2336
Mailing address
PO BOX 1793, KIRTLAND, NM 87417-1793
(505) 793-2336
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/02/2020
Last updated
01/02/2020
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