Healthcare Provider Details

I. General information

NPI: 1053714857
Provider Name (Legal Business Name): LAURA GARCIA-VALENZUELA LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2014
Last Update Date: 10/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 ABAJO RD SE
ALBUQUERQUE NM
87102-5105
US

IV. Provider business mailing address

340 ABAJO RD SE
ALBUQUERQUE NM
87102-5105
US

V. Phone/Fax

Practice location:
  • Phone: 505-903-1700
  • Fax:
Mailing address:
  • Phone: 505-903-1700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberX-08837
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: