Individual
JANINE CHERYL DETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1574 STATE ROAD 502, SANTA FE, NM 87506-2697
(505) 455-2234
Mailing address
1574 STATE ROAD 502, SANTA FE, NM 87506-2697
(505) 455-2234
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
316925
NM
Other
Enumeration date
01/14/2009
Last updated
01/14/2009
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