Healthcare Provider Details

I. General information

NPI: 1427248913
Provider Name (Legal Business Name): SHIRLEY M. TURCO, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2007
Last Update Date: 07/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10220 LA PAZ DR NW
ALBUQUERQUE NM
87114-4925
US

IV. Provider business mailing address

10220 LA PAZ DR NW
ALBUQUERQUE NM
87114-4925
US

V. Phone/Fax

Practice location:
  • Phone: 505-304-0668
  • Fax: 505-899-4831
Mailing address:
  • Phone: 505-304-0668
  • Fax: 505-899-4831

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI-06189
License Number StateNM

VIII. Authorized Official

Name: SHIRLEY M. TURCO
Title or Position: OWNER
Credential: LISW
Phone: 505-304-0668