Individual
MS. RENEE L LEVALDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8300 CONSTITUTION AVE NE, ALBUQUERQUE, NM 87110-7613
(505) 917-4585
Mailing address
PO BOX 338, NEW LAGUNA, NM 87038-0338
(505) 917-4585
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111568766
NM DRIVERS LICENSE
NM
Enumeration date
12/30/2019
Last updated
01/03/2025
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