Individual
MRS. EDNA ELIZABETH GONZALES-ANZALDUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW,LADAC
Contact information
Practice address
818 S MCCURDY RD, ESPANOLA, NM 87532-9646
(505) 747-7223
Mailing address
PO BOX 109, HERNANDEZ, NM 87537-0109
(505) 747-7223
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0118251
NM
1041C0700X
Clinical Social Worker
Primary
I-08202
NM
Other
Enumeration date
11/30/2006
Last updated
07/19/2013
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