Kanisha Chavez
NPI #1942162300 in Santo Domingo Pueblo, New Mexico
Provider Information
- NPI Number
- 1942162300
- Entity Type
- Individual
- Name
- Kanisha Chavez
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Community/Behavioral Health
- Enumeration Date
- Nov 24, 2025
- Last Updated
- Nov 24, 2025
Practice Location
- Address
- PO BOX 130
- Address 2
- 19 CEDAR TREE PARK
- State
- New Mexico
- ZIP Code
- 87052-0130
- Phone
- (505) 585-0114
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community/Behavioral Health |
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