Individual
MIRANDA ADELITA MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1201 PARKWAY DR # B, SANTA FE, NM 87507-7258
(505) 508-0865
Mailing address
RR 4 BOX 5B, HERNANDEZ, NM 87537-9706
(505) 423-0648
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/28/2021
Last updated
04/28/2021
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