Individual
MRS. SUZANNE NORA MANCIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.C.B.A.
Contact information
Practice address
117 SIERRA BLANCA AVE, TULAROSA, NM 88352
(575) 415-5220
Mailing address
117 SIERRA BLANCA AVE, TULAROSA, NM 88352
(575) 415-5220
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-16-22314
—
Other
Enumeration date
01/03/2017
Last updated
01/03/2017
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