Healthcare Provider Details

I. General information

NPI: 1003809013
Provider Name (Legal Business Name): FRANCE BORDELEAU L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 12/27/2024
Certification Date: 12/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 GOLD AVE SW STE 102
ALBUQUERQUE NM
87102-3187
US

IV. Provider business mailing address

10405 CASADOR DEL OSO NE STE 104
ALBUQUERQUE NM
87111-3772
US

V. Phone/Fax

Practice location:
  • Phone: 505-710-8423
  • Fax:
Mailing address:
  • Phone: 505-710-8423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC-06163
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: