Individual
CAROLINE ELIZABETH KENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
GED
Contact information
Practice address
3440 ANDERSON AVE SE, ALBUQUERQUE, NM 87106-2408
(843) 609-8935
Mailing address
3440 ANDERSON AVE SE, ALBUQUERQUE, NM 87106-2408
(843) 609-8935
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZCV255144087250
BLUE CROSS BLUE SHIELD
SC
Enumeration date
10/24/2017
Last updated
10/24/2017
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