Individual
MRS. MARIANNE CANDELARIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
343 MAIN ST. SE, LOS LUNAS, NM 87031
(505) 866-8340
Mailing address
1836 APPLEWOOD LN, LOS LUNAS, NM 87031-8617
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
C-4607
NM
Other
Enumeration date
09/10/2009
Last updated
09/10/2009
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