Individual
MRS. CASSANDRA MARIE MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BT
Contact information
Practice address
1551 CASTLEPL SE, B, ALBUQUERQUE, NM 87116
(801) 648-5269
Mailing address
1551 CASTLEPL SE, B, ALBUQUERQUE, NM 87116
(801) 648-5269
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1546681366
TRICARE
NM
Enumeration date
09/06/2018
Last updated
09/24/2018
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