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Diana Licon — NPI 1326908005, Santa Teresa, NM | NPI Central

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NPI 1326908005

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Diana Licon

NPI 1326908005 · Community Health Worker · Santa Teresa, NM

Provider details

NPI number: 1326908005
Entity type: Individual
Primary specialty: Community Health WorkerOther Service Providers
Sex: Female
Sole proprietor: No

Specialties & taxonomies

Community Health WorkerPrimary172V00000X
Other Service Providers

Practice location

5805 Mcnutt Rd

Santa Teresa, NM 88008-8001

Phone: (575) 332-4007

Approximate (ZIP-level) locationGet directions

More NM providers

Mailing address

5805 Mcnutt Rd

Santa Teresa, NM 88008-8001

Registry dates

Enumerated: 2025-11-14
Last updated: 2025-11-14
Certified: 2025-11-14

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.