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Organization

PRECIOUS MEMORIESDOULA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EVONNIE FOMENTO SBD (OWNER)
(505) 990-9408
Entity
Organization

Contact information

Practice address
1231 DESERT PAINTBRUSH LOOP NE, RIO RANCHO, NM 87144-2608
(505) 990-9408
Mailing address
1231 DESERT PAINTBRUSH LOOP NE, RIO RANCHO, NM 87144-2608
(505) 990-9408

Taxonomy

Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
4962281
NM

Other

Enumeration date
10/28/2014
Last updated
10/28/2014
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