Individual
GLENDA MAZON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
13 EAST OLD AGUA FRIA ROAD, SANTA FE, NM 87508-5970
(505) 988-1169
(505) 982-4053
Mailing address
13 EAST OLD AGUA FRIA ROAD, SANTA FE, NM 87508-5970
(505) 988-1169
(505) 982-4053
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
M-04977
NM
Other
Enumeration date
11/20/2014
Last updated
11/20/2014
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