Individual
TAMARA SANDOVAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8 RIVERSIDE RD, ALGODONES, NM 87001-5033
(970) 234-5112
Mailing address
122 BLACK MESA UNIT 4188, ALGODONES, NM 87001-8119
(970) 234-5112
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/02/2021
Last updated
01/02/2021
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