Healthcare Provider Details

I. General information

NPI: 1336291020
Provider Name (Legal Business Name): MEREDITH ANN LINK MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. MEREDITH ANN HINCK

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1503 UNIVERSITY BLVD NE
ALBUQUERQUE NM
87102-1708
US

IV. Provider business mailing address

13016 SAND CHERRY PL NE
ALBUQUERQUE NM
87111-7570
US

V. Phone/Fax

Practice location:
  • Phone: 505-243-2551
  • Fax:
Mailing address:
  • Phone: 505-822-6396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberM-05650
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: