Individual
DR. MARY ELLEN MARINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DOM,N.D.
Contact information
Practice address
1925 ASPEN DR, 302 B, SANTA FE, NM 87505-5459
(505) 455-0005
Mailing address
RT 5 BOX 279A, SANTA FE, NM 87506
(505) 455-0005
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
346
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NMOOR434
BLUE CROSS BLUE SHEILD
NM
Enumeration date
01/03/2007
Last updated
07/08/2007
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