Healthcare Provider Details

I. General information

NPI: 1104647320
Provider Name (Legal Business Name): MRS. KATHRYN L SANCHEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2024
Last Update Date: 10/21/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 680
SILVER CITY NM
88062-0680
US

IV. Provider business mailing address

PO BOX 680
SILVER CITY NM
88062-0680
US

V. Phone/Fax

Practice location:
  • Phone: 575-538-6011
  • Fax:
Mailing address:
  • Phone: 575-538-6011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSWB-2024-0919
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: