Organization
SPECIAL CONCERNS OF WOMEN AND CHILDREN
Active
Organization
SPECIAL CONCERNS OF WOMEN AND CHILDREN
Active
Other names
Livingwell
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL MINTIE (OWNER)
(505) 792-4519
Entity
Organization
Contact information
Practice address
312 WAYNE RD NW, LOS RANCHOS, NM 87114-1028
(505) 792-4519
Mailing address
312 WAYNE RD NW, LOS RANCHOS, NM 87114-1028
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-06493
NM
Other
Enumeration date
07/01/2011
Last updated
07/01/2011
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