Individual
KYETIIL SHANTELLE VICENTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
REGINALD HEBER FITZ HALL ROOM 107, ALBUQUERQUE, NM 87131-0001
(505) 272-3414
Mailing address
MSC08 4700 1 UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131-0001
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/04/2023
Last updated
09/04/2023
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