Individual
LISA M MURDOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
28 ROAD 6361 TRLR 46, KIRTLAND, NM 87417-9694
(505) 635-0380
Mailing address
PO BOX 574, KIRTLAND, NM 87417-0574
(505) 635-0380
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/16/2020
Last updated
03/16/2020
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