MEDICARE: MRS. ALICIA SANCHEZ LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041S0200X	School Social Worker	M-04803	NM

General Provider Information

NPI Number	:	1003932757
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALICIA SANCHEZ LMSW

Provider Business Mailing Address
First Line	:	1301 BROADVIEW LOOP NW
Second Line	:
City	:	LOS LUNAS
State	:	NM
Zip	:	87031-8360
Country	:	US
Telephone Number	:	505-319-7225
Fax Number	:

Provider Business Practice Location Address
First Line	:	2300 ARENAL RD SW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87105-4160
Country	:	US
Telephone Number	:	505-319-7225
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2007
Last Update Date	:	07/08/2007

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