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General NPI Number Information
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NPI Number | 1679582910
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Entity Type | Individual
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Provider Name | SHARA KRANZ LISW
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Gender | Female
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 07/18/2019
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Provider Practice Location Address
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Address Line | 5310 HOMESTEAD RD NE STE 300
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-1524
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Country | US
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Telephone | 505-503-6838
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Fax |
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Provider Business Mailing Address
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Address Line | 10821 CLYBURN PARK DR NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87123-4887
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Country | US
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Telephone | 505-604-9754
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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 | C-05183
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License Number State | NM
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