Individual
MAIJA SANTISTEVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCHW
Contact information
Practice address
1329 GUSDORF RD, TAOS, NM 87571-6282
(575) 779-4043
Mailing address
1329 GUSDORF RD, TAOS, NM 87571-6282
(575) 779-4043
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
G-1335
NM
Other
Enumeration date
08/01/2023
Last updated
08/01/2023
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