Healthcare Provider Details

I. General information

NPI: 1154442762
Provider Name (Legal Business Name): CECILIA GALARZA SW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ODELIA RD NE ALBUQUERQUE HS
ALBUQUERQUE NM
87102-1619
US

IV. Provider business mailing address

800 ODELIA RD NE ALBUQUERQUE HS
ALBUQUERQUE NM
87102-1619
US

V. Phone/Fax

Practice location:
  • Phone: 505-843-6400
  • Fax:
Mailing address:
  • Phone: 505-843-6400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberM 05326
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: