Individual
JORGE EDUARDO TARANGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
119 LUNA AVENUE, LOS LUNAS, NM 87031
(505) 865-9636
Mailing address
843 MONTE VISTA DR. NE, LOS LUNAS, NM 87031
(505) 639-2543
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103K00000X
Behavior Analyst
—
—
1041S0200X
School Social Worker
Primary
—
—
Other
Enumeration date
03/07/2014
Last updated
07/21/2022
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