Individual
MS. JEANETTE MARIE DEANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
34 MONTICELLO DR NE, ALBUQUERQUE, NM 87123-9601
(505) 453-6952
Mailing address
34 MONTICELLO DR NE, ALBUQUERQUE, NM 87123-9601
(505) 453-6952
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4860
NM
Other
Enumeration date
07/01/2016
Last updated
07/01/2016
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