Individual
DIANA PADILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1235 8TH ST, LAS VEGAS, NM 87701-4219
(505) 425-9464
Mailing address
PO BOX 158, ESPANOLA, NM 87532-0158
(505) 753-7218
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0146001
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
76171507
—
NM
Enumeration date
04/28/2014
Last updated
08/19/2015
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