Individual
VICENTE AVILA MIRAMONTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LBSW
Contact information
Practice address
13A SAN MARCOS LOOP, SANTA FE, NM 87508-7083
(505) 986-4007
Mailing address
13A SAN MARCOS LOOP, SANTA FE, NM 87508-7083
(505) 986-4007
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
392885
NM
Other
Enumeration date
10/16/2019
Last updated
10/16/2019
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