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General NPI Number Information
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NPI Number | 1598830838
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Entity Type | Individual
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Provider Name | CHERYL ANN GARDOPEE MSW, LISW
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Gender | Female
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2019 GALISTEO ST SUITE M-2
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City | SANTA FE
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State | NM
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Zip | 87505-2143
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Country | US
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Telephone | 505-984-8431
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Fax |
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Provider Business Mailing Address
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Address Line | 1880 BRILLANTE LN
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City | SANTA FE
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State | NM
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Zip | 87505-5642
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Country | US
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Telephone | 505-984-8431
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1-0064 LISW
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License Number State | NM
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