Individual
MARIAH KRISTINE PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1420 CARLISLE BLVD NE STE 100, ALBUQUERQUE, NM 87110-5662
(818) 241-6780
Mailing address
1500 S AVE K, SATION 3, SHROC, PORTALES, NM 88130
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/28/2019
Last updated
08/03/2021
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