Individual
DAKOTA BLU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1211 NEW YORK AVE, ALAMOGORDO, NM 88310-6727
(575) 386-8127
Mailing address
103 FRESNO ST, TULAROSA, NM 88352-2739
(575) 386-8127
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
G-1914
NM
Other
Enumeration date
02/02/2026
Last updated
02/02/2026
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