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General NPI Number Information
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NPI Number | 1245154004
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Entity Type | Individual
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Provider Name | ALICIA MARIA URIOSTE PROVISIONAL LMSW
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Gender | Female
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Dates
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Enumeration Date | 08/05/2026
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Last Update Date | 08/05/2026
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Provider Practice Location Address
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Address Line | 1574 STATE ROAD 502
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City | SANTA FE
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State | NM
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Zip | 87506-2697
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Country | US
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Telephone | 505-455-2282
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Fax |
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Provider Business Mailing Address
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Address Line | 2 PRIVATE DRIVE 1529
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City | HERNANDEZ
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State | NM
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Zip | 87537-8014
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Country | US
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Telephone | 505-429-2827
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SWB-2026-0651
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License Number State | NM
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