Individual
OLIVIA MENDOZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2917 FRUTAS AVE, EL PASO, TX 79905-1007
(915) 841-8239
Mailing address
5047 SAGITTARIUS AVE, EL PASO, TX 79924-2328
(915) 841-8239
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/07/2016
Last updated
04/07/2016
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