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Individual

JEANNE M WENZKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LISW

Contact information

Practice address
1450 S SAINT FRANCIS DR, SANTA FE, NM 87505-4038
(505) 944-5560
Mailing address
1004 CAMINO DE CHELLY, SANTA FE, NM 87505-6263
(505) 944-5560

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
I-07313
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
42121345
NM
Enumeration date
05/07/2010
Last updated
12/13/2010
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