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NPI Code Detail

MEDICARE: ALETA MCDONALD

MEDICARE:   ALETA  MCDONALD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerM-10522NM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1M-10522OTHERNMSTATE LICENSE

General Provider Information

NPI Number : 1487117917
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALETA MCDONALD
Provider Business Mailing Address
First Line : 500 UNSER BLVD SE STE 103
Second Line :
City : RIO RANCHO
State : NM
Zip : 87124-4660
Country : US
Telephone Number : 505-730-7195
Fax Number :
Provider Business Practice Location Address
First Line : 500 UNSER BLVD SE STE 103
Second Line :
City : RIO RANCHO
State : NM
Zip : 87124-4660
Country : US
Telephone Number : 505-730-7195
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2019
Last Update Date : 04/11/2019

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Directions to “ ALETA MCDONALD ” Practice Location

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