Individual
JAZZMIN MELISSA GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2628 ASH ST, SANTA FE, NM 87507-9293
(505) 603-9652
Mailing address
2628 ASH ST, SANTA FE, NM 87507-9293
(505) 603-9652
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1700146314
NM
Other
Enumeration date
12/07/2017
Last updated
12/07/2017
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