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Individual

MICHELLE ANN MARIE BACA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6121 INDIAN SCHOOL RD NE STE 141, ALBUQUERQUE, NM 87110-3176
(505) 888-1362
Mailing address
6121 INDIAN SCHOOL RD NE STE 141, ALBUQUERQUE, NM 87110-3176

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
M-10509
NM
1041C0700X
Clinical Social Worker

Other

Enumeration date
09/29/2020
Last updated
09/29/2020
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