Individual
PATRICIA ULLOA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPSW
Contact information
Practice address
105 W GRIGGS AVE, LAS CRUCES, NM 88001-1235
(575) 647-2879
(575) 647-2898
Mailing address
385 CALLE DE ALEGRA STE A, LAS CRUCES, NM 88005-3423
(575) 526-1105
(575) 524-4266
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
976
NM
175T00000X
Peer Specialist
97
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
NM
Enumeration date
02/16/2020
Last updated
10/13/2020
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