Healthcare Provider Details

I. General information

NPI: 1003932757
Provider Name (Legal Business Name): ALICIA SANCHEZ LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 ARENAL RD SW
ALBUQUERQUE NM
87105-4160
US

IV. Provider business mailing address

1301 BROADVIEW LOOP NW
LOS LUNAS NM
87031-8360
US

V. Phone/Fax

Practice location:
  • Phone: 505-319-7225
  • Fax:
Mailing address:
  • Phone: 505-319-7225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberM-04803
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: