Healthcare Provider Details

I. General information

NPI: 1982838983
Provider Name (Legal Business Name): SARAH ISABEL ARMIJO LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2009
Last Update Date: 05/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2516 VERANDA RD NW # 2
ALBUQUERQUE NM
87107-2985
US

IV. Provider business mailing address

2516 VERANDA RD NW # 2
ALBUQUERQUE NM
87107-2985
US

V. Phone/Fax

Practice location:
  • Phone: 505-249-3808
  • Fax:
Mailing address:
  • Phone: 505-249-3808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI-06978
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLMSW-12539
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: