Individual
ALYSSA KERMODE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2314 N GARDEN AVE, ROSWELL, NM 88201-7621
(575) 416-1774
Mailing address
2314 N GARDEN AVE, ROSWELL, NM 88201-7621
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/02/2021
Last updated
06/02/2021
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