Individual
NICOLAS LORENZO NIETO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPSW
Contact information
Practice address
912 1ST ST NW, ALBUQUERQUE, NM 87102-2355
(505) 224-9777
Mailing address
912 1ST ST NW, ALBUQUERQUE, NM 87102-2355
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
1363
NM
Other
Enumeration date
07/21/2022
Last updated
07/21/2022
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