Individual
JODIE L HART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
608 BLEDSOE RD NW, LOS RANCHOS, NM 87107-6219
(505) 450-8007
Mailing address
3326 LINDA VISTA AVE SE, ALBUQUERQUE, NM 87106-1514
(505) 450-8007
(505) 268-8949
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
M-06061
NM
1041C0700X
Clinical Social Worker
Primary
X-06862
NM
Other
Enumeration date
09/28/2009
Last updated
02/01/2010
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