Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003112319 |
---|---|
Provider Name | Krystal Torrez |
First Address | Albuquerque, NM 87107-3752 |
Second Address | Albuquerque, NM 87107-3752 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2011 |
Last Update Date | 03/02/2011 |