Individual
MS. JORDAN ALICIA RODRIGUEZ PECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
901 RIO GRANDE BLVD NW STE G252, ALBUQUERQUE, NM 87104-2059
(505) 702-8112
Mailing address
6029 PLACER DR NE, ALBUQUERQUE, NM 87111-5939
(813) 502-8305
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
M-11444
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M-11444
LMSW LICENSING NUMBER
NM
Enumeration date
06/30/2021
Last updated
06/30/2021
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