Individual
REBECCA CHAVEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
199 LOWER SAN PEDRO RD, ESPANOLA, NM 87532-8500
(505) 339-7532
Mailing address
PO BOX 1795, SANTA CRUZ, NM 87567-1795
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/22/2020
Last updated
07/22/2020
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