Individual
MARISSA HEDRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
707 BROADWAY BLVD NE, SUITE 103, ALBUQUERQUE, NM 87102-2360
(505) 933-4639
Mailing address
707 BROADWAY BLVD NE, SUITE 103, ALBUQUERQUE, NM 87102-2360
(505) 933-4639
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
M-07116
NM
Other
Enumeration date
08/05/2016
Last updated
08/05/2016
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