Melody Michelle Benavidez

Individual provider Active NPI Behavior Technician · Moriarty, NM

NPI 1275375396 · NPPES record last updated Jun 10, 2024

Key facts

NPI
1275375396
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
67 Hermosa Ave
Moriarty, NM 87035-5592
Phone
(505) 907-5161
NPI assigned
Jun 10, 2024
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

67 Hermosa Ave
Moriarty, NM 87035-5592

Mailing address

67 Hermosa Ave
Moriarty, NM 87035-5592
Phone (505) 907-5161

Other providers in Moriarty, NM

All providers in Moriarty, NM · Behavior Technician in New Mexico

Sources for this page

Verify at the official NPI Registry.