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General NPI Number Information
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NPI Number | 1053710004
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Entity Type | Organization
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Legal Business Name | REGION IX EDUCATION COOPERATIVE
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Dates
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Enumeration Date | 08/15/2014
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Last Update Date | 08/15/2014
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Provider Practice Location Address
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Address Line | 237 SERVICE RD
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City | RUIDOSO
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State | NM
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Zip | 88345-6063
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Country | US
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Telephone | 575-257-2368
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Fax |
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Provider Business Mailing Address
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Address Line | 237 SERVICE RD
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City | RUIDOSO
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State | NM
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Zip | 88345-6063
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Country | US
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Telephone | 575-257-2368
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Fax |
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Authorized Official
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Title or Position | MEDICAID TECH
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Name | EVELYN SANCHEZ
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Credential |
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Telephone | 575-937-2497
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 299611
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License Number State | NM
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