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General NPI Number Information
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NPI Number | 1871731315
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Entity Type | Individual
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Provider Name | CHLOE DENISE EDGAR LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/21/2009
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Last Update Date | 09/04/2024
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Provider Practice Location Address
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Address Line | 6612 GULTON CT NE STE B
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-4407
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Country | US
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Telephone | 505-918-8880
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Fax | 505-521-5165
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Provider Business Mailing Address
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Address Line | 6612 GULTON CT NE STE B
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-4407
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Country | US
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Telephone | 505-918-8880
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Fax | 505-521-5165
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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 | M-07322
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C-08255
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License Number State | NM
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