Healthcare Provider Details

I. General information

NPI: 1003741927
Provider Name (Legal Business Name): AIDEN MORALES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2026
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2616 MESILLA ST NE STE 3
ALBUQUERQUE NM
87110-3659
US

IV. Provider business mailing address

2616 MESILLA ST NE STE 3
ALBUQUERQUE NM
87110-3659
US

V. Phone/Fax

Practice location:
  • Phone: 505-588-7571
  • Fax:
Mailing address:
  • Phone: 505-588-7571
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSWB-2026-0737
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: