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Individual

MRS. JOHNNETTA M CHESTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
530B HARKLE RD STE 100, SANTA FE, NM 87505-4739
(505) 629-0009
Mailing address
298 FAIRWAY WOODS DR, LAS VEGAS, NV 89148-5203
(702) 955-8433

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
01/27/2023
Last updated
01/27/2023
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