Individual
MARIANA DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
143 EL PASO RD, RUIDOSO, NM 88345-6033
(575) 257-2368
Mailing address
143 EL PASO RD, RUIDOSO, NM 88345-6033
(575) 257-2358
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
401186
NM
Other
Enumeration date
09/29/2020
Last updated
09/29/2020
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