Individual
ANAYSA CORONADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4801 MONTANO RD NW STE A2, ALBUQUERQUE, NM 87120-2423
(505) 336-0560
Mailing address
PO BOX 663, LAKELAND, MI 48143-0663
(734) 203-0181
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/03/2024
Last updated
04/11/2024
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