Healthcare Provider Details

I. General information

NPI: 1467975870
Provider Name (Legal Business Name): VALENCIA ZAH LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2017
Last Update Date: 03/31/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 MEDICINE HORSE DR.
TO'HAJIILEE NM
87026
US

IV. Provider business mailing address

129 MEDICINE HORSE DR.
TO'HAJIILEE NM
87026
US

V. Phone/Fax

Practice location:
  • Phone: 505-908-2307
  • Fax: 505-908-2306
Mailing address:
  • Phone: 505-908-2307
  • Fax: 505-908-2306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWB-2024-0718
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: