Healthcare Provider Details

I. General information

NPI: 1760731566
Provider Name (Legal Business Name): JOAQUIN TOBIAS ARGUELLO LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2012
Last Update Date: 09/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1317 ISLETA BLVD SW
ALBUQUERQUE NM
87105-4035
US

IV. Provider business mailing address

414 COLUMBIA DR SE APT A
ALBUQUERQUE NM
87106-3618
US

V. Phone/Fax

Practice location:
  • Phone: 505-312-7296
  • Fax:
Mailing address:
  • Phone: 505-417-9652
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberM-07604
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberM-07604
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: