MEDICARE: VERONICA DIANE PUENTES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	247200000X	Other Technician
2	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1194269829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VERONICA DIANE PUENTES

Provider Business Mailing Address
First Line	:	2305 RENARD PL SE STE 110
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87106-4258
Country	:	US
Telephone Number	:	718-215-5311
Fax Number	:	505-226-3299

Provider Business Practice Location Address
First Line	:	2305 RENARD PL SE STE 110
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87106-4258
Country	:	US
Telephone Number	:	505-230-3790
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2016
Last Update Date	:	08/27/2025

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Directions to “ VERONICA DIANE PUENTES ” Practice Location

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