Individual
GARY LEE ANGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
218 MERLIDA CT SW, ALBUQUERQUE, NM 87121-2390
(505) 934-0679
Mailing address
218 MERLIDA CT SW, ALBUQUERQUE, NM 87121-2390
(505) 934-0679
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/02/2018
Last updated
10/02/2018
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