Individual
ELICEA MARIE COCA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5 VISTA DEL RIO, PERALTA, NM 87042-4801
(505) 301-2505
Mailing address
5 VISTA DEL RIO, PERALTA, NM 87042-4801
(505) 301-2505
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/07/2023
Last updated
06/07/2023
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