Individual
MICHELLE BLUMENTHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1051 CONNECTICUT AVE, HOLLOMAN AFB, NM 88330-8092
(575) 572-2529
Mailing address
3303 FAYNE LN, ALAMOGORDO, NM 88310-8209
(575) 415-9837
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/16/2019
Last updated
04/16/2019
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