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Individual

ERICK A STRUCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LISW

Contact information

Practice address
1331 GUSDORF RD, TAOS, NM 87571-6282
(575) 758-3601
(575) 758-1058
Mailing address
538 N PASEO DE ONATE, P.O. BOX 158, ESPANOLA, NM 87532-2618
(505) 753-7218
(505) 753-5815

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-08242
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39822869
NM
Enumeration date
08/01/2011
Last updated
07/01/2013
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