Individual
MARCELLA MAESTAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
612 N PASEO DE ONATE, ESPANOLA, NM 87532-2963
(505) 753-2203
(505) 747-1881
Mailing address
PO BOX 520, ESPANOLA, NM 87532-0520
(505) 753-2203
(505) 747-1881
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
E7436
—
NM
Enumeration date
07/23/2013
Last updated
10/21/2015
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