Individual
JUAN CARLOS DEOSES BURCIAGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2504 CAMINO ENTRADA, SANTA FE, NM 87507-4851
(505) 471-5006
(505) 820-9220
Mailing address
2504 CAMINO ENTRADA, SANTA FE, NM 87507-4851
(505) 471-5006
(505) 820-9220
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
104100000X
Social Worker
M-10237
NM
1041C0700X
Clinical Social Worker
Primary
C-11414
NM
1041S0200X
School Social Worker
372693
NM
Other
Enumeration date
10/23/2017
Last updated
09/09/2021
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