Diana Licon

NPI 1326908005 · on the registry since 2025

Practice

Address: 5805 Mcnutt Rd
Santa Teresa, NM 88008
Phone: (575) 332-4007
Organisation at this address: Stf Dental
Green Minds Matter Llc
Southwest Psychiatry Pllc
Monte Cristo Home Health Llc
South West Medical Transport Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 9

Registry record

Primary taxonomy: 172V00000X
172V00000X
Licence states on file: NM
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2025-11-14

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New Mexico