Most Relevant Information
Provider Data
| NPI Number: | 1003635517 |
| Provider Name: | THEA CAROLYN KAVANAUGH |
| Entity Type: | Individual |
| Taxonomy Code: | 174H00000X |
| Specialty: | Health Educator |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/10/2024 |
| Last Updated: | 10/10/2024 |
Provider Practice Location
4527 GALISTEO LOOP
LAS CRUCES
NM
880114301
Practice Location Phone/Fax
| Phone: | 5756359013 |
| Fax: |
Provider Mailing Location
4527 GALISTEO LOOP
LAS CRUCES
NM
880114301
Provider Mailing Phone/Fax
| Phone: | 5756359013 |
| Fax: |