Individual
ALEXANDRIA MARY BACA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5600 GIBSON BLVD SE APT 368, ALBUQUERQUE, NM 87108-5455
(505) 850-4295
Mailing address
5600 GIBSON BLVD SE APT 368, ALBUQUERQUE, NM 87108-5455
(505) 850-4295
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
515268677
NM
Other
Enumeration date
08/18/2020
Last updated
08/18/2020
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