Individual
LOUCRETIA JOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2700 E 7TH ST, CLOVIS, NM 88101-1708
(575) 762-3718
Mailing address
2700 E 7TH ST, CLOVIS, NM 88101-1708
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/04/2015
Last updated
06/04/2015
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