Individual
ARIANA ALICIA DEAN CARRILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
601 MAIN ST SE, LOS LUNAS, NM 87031-4308
(505) 508-3503
Mailing address
1816 REGENCY PARK RD SE, RIO RANCHO, NM 87124-7114
(505) 414-5484
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
NM
Other
Enumeration date
01/11/2018
Last updated
01/11/2018
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