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1528825189
TAYLOR EARNEST DOMEK
LAS CRUCES, NM
NPI
1528825189
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
(Licence: NM 1701)
Enumeration Date
2024-02-29
Last Update Date
2024-02-29
Business Address
TAYLOR EARNEST DOMEK CPSW
999 W AMADOR AVE STE A
LAS CRUCES, NM 88005-2739
Phone number: 575-527-5482
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Mailing Address
TAYLOR EARNEST DOMEK CPSW
PO BOX 2243
LAS CRUCES, NM 88004-2243
Phone number: 575-527-5482
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