Individual
STEPHANIE CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1302 CALLE DE LA MERCED STE H, ESPANOLA, NM 87532-2630
(505) 747-0081
(505) 747-0083
Mailing address
1302 CALLE DE LA MERCED STE H, ESPANOLA, NM 87532-2630
(505) 747-0081
(505) 747-0083
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
E7436
—
NM
Enumeration date
09/29/2009
Last updated
12/08/2010
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