Individual
MISS MADELEINE FISHER LARSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
529 E PALACE AVE, SANTA FE, NM 87501-2200
(505) 920-4296
Mailing address
529 E PALACE AVE, SANTA FE, NM 87501-2200
(505) 920-4296
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/08/2019
Last updated
08/08/2019
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