Individual
MIA ISABELLA SANDOVAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
228 SPRUCE ST NE, ALBUQUERQUE, NM 87106-4637
(956) 975-4490
Mailing address
7000 PROSPECT PL NE, ALBUQUERQUE, NM 87110-4359
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/30/2024
Last updated
09/30/2024
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