Provider Demographics
NPI:1902043573
Name:AMARO, MARIA DOLORES
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:DOLORES
Last Name:AMARO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 W 21ST ST
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88101-4151
Mailing Address - Country:US
Mailing Address - Phone:575-763-3323
Mailing Address - Fax:575-769-9013
Practice Address - Street 1:300 E 5TH ST
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101-6604
Practice Address - Country:US
Practice Address - Phone:575-763-3323
Practice Address - Fax:575-769-8974
Is Sole Proprietor?:No
Enumeration Date:2009-01-19
Last Update Date:2009-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator