Provider Demographics
NPI:1265395446
Name:ROJO, DAISY LEONOR
Entity type:Individual
Prefix:
First Name:DAISY
Middle Name:LEONOR
Last Name:ROJO
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 1:3430 PRAIRIE SAGE ST SW
Mailing Address - Street 2:
Mailing Address - City:LOS LUNAS
Mailing Address - State:NM
Mailing Address - Zip Code:87031-6684
Mailing Address - Country:US
Mailing Address - Phone:661-885-5822
Mailing Address - Fax:
Practice Address - Street 1:3430 PRAIRIE SAGE ST SW
Practice Address - Street 2:
Practice Address - City:LOS LUNAS
Practice Address - State:NM
Practice Address - Zip Code:87031-6684
Practice Address - Country:US
Practice Address - Phone:661-885-5822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-04
Last Update Date:2025-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician