Individual
GILDA BERESFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5316 MILLER RD, LAS CRUCES, NM 88007-4880
(575) 541-9476
(575) 524-4266
Mailing address
385 CALLE DE ALEGRA STE A, LAS CRUCES, NM 88005-3423
(575) 526-1105
(575) 524-4266
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
74481
—
NM
Enumeration date
01/02/2014
Last updated
10/16/2015
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