Provider Information for 1124357603
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VIOLETA BLANCA JAURE LPCC, LADAC
Sex: Female
NPI: 1124357603
Last Updated: 2025-02-03
Certification Date: 2025-02-03
Certification Date: 2025-02-03
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1124357603 | ||||||||||||
| Enumeration Date | 2009-12-14 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 1801 AVENIDA DE MESILLA LAS CRUCES, NM 88005-3908 United States Phone: 575-323-1976 | Fax:505-272-8060 | ||||||||||||
| Primary Practice Address | 1801 AVENIDA DE MESILLA LAS CRUCES, NM 88005-3908 United States Phone: 575-323-1976 | Fax: | ||||||||||||
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