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NPI Code Detail

MEDICARE: REYNA ANDAZOLA

MEDICARE: REYNA ANDAZOLA
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
1106S00000XBehavior TechnicianRBT-26-529117NM

General Provider Information

NPI Number : 1457212607
Entity Type Code : Individual
Provider Name (Legal Business Name) : REYNA ANDAZOLA
Provider Business Mailing Address
First Line : 301 PERKINS DR STE B
Second Line :
City : LAS CRUCES
State : NM
Zip : 88005-3248
Country : US
Telephone Number : 575-526-6682
Fax Number :
Provider Business Practice Location Address
First Line : 1675 HICKORY LOOP
Second Line :
City : LAS CRUCES
State : NM
Zip : 88005-6587
Country : US
Telephone Number : 575-652-3155
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2025
Last Update Date : 06/24/2026

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Directions to “ REYNA ANDAZOLA ” Practice Location

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