Individual
MAYRA MARIA MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
678 AVENUE C, FT. SUMNER, NM 88119
(575) 355-8326
(575) 355-8327
Mailing address
PO BOX 28220, SANTA FE, NM 87592-8220
(505) 471-5006
(505) 820-9220
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/20/2010
Last updated
12/20/2010
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