TRACEY LA DAWN BULLOCK

PORTALES, NM
NPI1265948038
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy106S00000X Behavior Technician
(Licence: NM  RBT-16-22817)
Enumeration Date2017-12-15
Last Update Date2017-12-15
Business Address
Mrs. TRACEY LA DAWN BULLOCK RBT
830 W 14TH ST
PORTALES, NM 88130-6708
Phone number: 575-825-1229
Mailing Address
Mrs. TRACEY LA DAWN BULLOCK RBT
830 W 14TH ST
PORTALES, NM 88130-6708
Phone number: 575-825-1229
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