Individual
SANTANA MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PEER SUPPORT SPECIAL
Contact information
Practice address
3465 MCNUTT RD, SUNLAND PARK, NM 88063-9056
(575) 915-1338
(575) 915-1819
Mailing address
3465 MCNUTT RD, SUNLAND PARK, NM 88063-9056
(575) 915-1338
(575) 915-1819
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
2021
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
24256536
—
NM
Enumeration date
07/26/2019
Last updated
07/26/2019
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