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NPI Code Detail

MEDICARE: MRS. JUDY A DRISCOLL LMSW

MEDICARE: MRS. JUDY A DRISCOLL LMSW
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
11041C0700XClinical Social WorkerC-08048NM

General Provider Information

NPI Number : 1730370214
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JUDY A DRISCOLL LMSW
Provider Business Mailing Address
First Line : 2221 RIO GRANDE BLVD NW
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87104-2529
Country : US
Telephone Number : 505-688-0003
Fax Number :
Provider Business Practice Location Address
First Line : 2221 RIO GRANDE BLVD NW
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87104-2529
Country : US
Telephone Number : 505-688-0003
Fax Number : 505-800-0102
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2007
Last Update Date : 08/17/2016

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