Individual
AMANDA T CORIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
1200 N PASEO DE ONATE, ESPANOLA, NM 87532-2687
(505) 747-7400
Mailing address
835 SPRUCE ST STE C, ESPANOLA, NM 87532-3455
(505) 927-9221
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10547814100
—
NM
Enumeration date
06/20/2023
Last updated
06/29/2023
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