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General NPI Number Information
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NPI Number | 1639845779
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Entity Type | Individual
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Provider Name | ANEL NOHELI SOTO TENA
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Gender | Female
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Dates
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Enumeration Date | 08/18/2021
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Last Update Date | 08/18/2021
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Provider Practice Location Address
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Address Line | 4001 OFFICE COURT DR STE 706
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City | SANTA FE
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State | NM
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Zip | 87507-4958
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Country | US
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Telephone | 505-544-1800
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Fax |
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Provider Business Mailing Address
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Address Line | 12B LOS CIELOS LN
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City | SANTA FE
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State | NM
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Zip | 87507-8533
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Country | US
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Telephone | 505-544-1800
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | 513243189
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License Number State | NM
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