Individual
MARTHA WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1020 EL PUEBLO RD NW, LOS RANCHOS, NM 87114-1203
(505) 259-9865
Mailing address
1020 EL PUEBLO RD NW, LOS RANCHOS, NM 87114-1203
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
24-75798
NM
Other
Enumeration date
04/29/2021
Last updated
02/04/2025
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