Individual
MRS. GINA LORRAINE DELUCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2960 RODEO PARK DR W, SANTA FE, NM 87505-6351
(505) 986-9633
Mailing address
2960 RODEO PARK DR W, SANTA FE, NM 87505-6351
(505) 986-9633
(505) 473-3038
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
C-09792
NM
1041C0700X
Clinical Social Worker
Primary
C-09792
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
E7436
—
NM
Enumeration date
10/08/2012
Last updated
10/01/2023
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