Individual
JADE SHIKIKO WAGELEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
51 CRUCES LOOP, LOS LUNAS, NM 87031-0015
(505) 378-7534
Mailing address
51 CRUCES LOOP, LOS LUNAS, NM 87031-0015
(505) 378-7534
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
04/30/2025
Last updated
04/30/2025
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