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707 Woodlands Way Cloudcroft NM 88317-7790 | |
| (303) 775-7723 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Behavior Analyst |
| Location | 707 Woodlands Way, Cloudcroft, New Mexico |
| Authorized Official Name and Position | Shyll Bowen (MEMBER) |
| Authorized Official Contact | 3037757723 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
707 Woodlands Way Cloudcroft NM 88317-7790 Ph: (303) 775-7723 | 707 Woodlands Way Cloudcroft NM 88317-7790 Ph: (303) 775-7723 |
| NPI Number | 1689353310 |
|---|---|
| Provider Enumeration Date | 07/11/2023 |
| Last Update Date | 08/23/2023 |
| Certification Date | 08/23/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689353310 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |