TEDDEY PROVENCIO

LAS CRUCES, NM
NPI1407158298
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Enumeration Date2010-11-30
Last Update Date2010-11-30
Business Address
-- TEDDEY PROVENCIO
118 S MAIN ST
LAS CRUCES, NM 88001
Phone number: 575-527-7975
Mailing Address
-- TEDDEY PROVENCIO
100 W GRIGGS AVE
LAS CRUCES, NM 88001-1234
Phone number: 575-647-2800