Individual
DOMINIQUE ANGEL SANTILLANES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2504 CAMINO ENTRADA, SANTA FE, NM 87507-4851
(505) 216-2727
Mailing address
PO BOX 28164, SANTA FE, NM 87592-8164
(505) 216-2727
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
M-11419
NM
Other
Enumeration date
03/24/2022
Last updated
02/12/2024
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