Healthcare Provider Details

I. General information

NPI: 1821911272
Provider Name (Legal Business Name): ABA SOUTHWEST NM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3621 MARION LN
LAS CRUCES NM
88012-7579
US

IV. Provider business mailing address

3621 MARION LN
LAS CRUCES NM
88012-7579
US

V. Phone/Fax

Practice location:
  • Phone: 575-520-6074
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MONIQUE LUJAN
Title or Position: OWNER
Credential: LBA
Phone: 575-520-6074