Individual
ELISA VAZQUEZ ENRIQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LISW
Contact information
Practice address
809 RIO VISTA ST, SANTA FE, NM 87501-1549
(505) 690-1138
Mailing address
809 RIO VISTA ST, SANTA FE, NM 87501-1549
(505) 690-1138
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-05165
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39636852
—
NM
Enumeration date
04/13/2007
Last updated
07/09/2007
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