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Individual

MS. AUTUMN DRAGS WOLF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
11005 SPAIN RD NE STE 15, ALBUQUERQUE, NM 87111-1871
(505) 715-9673
Mailing address
1035 DON ROMERO DR SW, ALBUQUERQUE, NM 87105-3996
(505) 715-9673

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
X-08328
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1124458633
NM
Enumeration date
11/19/2013
Last updated
02/13/2019
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