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General NPI Number Information
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NPI Number | 1962772400
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Entity Type | Organization
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Legal Business Name | MARCY A. HAIG LISW LLC
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Dates
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Enumeration Date | 12/30/2011
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Last Update Date | 12/30/2011
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Provider Practice Location Address
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Address Line | 2074 GALISTEO STR. STE. A1
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City | SANTA FE
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State | NM
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Zip | 87505-2104
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Country | US
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Telephone | 505-983-6432
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Fax | 505-983-6432
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Provider Business Mailing Address
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Address Line | 2074 GALISTEO STR. STE A1
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City | SANTA FE
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State | NM
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Zip | 87505-2104
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Country | US
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Telephone | 505-983-6432
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Fax | 505-983-6432
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Authorized Official
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Title or Position | LICENSED INDEPENDENT SOCIAL WORKER
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Name | MS. MARCY A. HAIG
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Credential | LISW
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Telephone | 505-983-6432
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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 | I-0079
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License Number State | NM
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