Individual
DESIREE CARLILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2600 MARBLE AVE NE, ALBUQUERQUE, NM 87106-2058
(505) 272-2409
Mailing address
2600 MARBLE AVE NE, ALBUQUERQUE, NM 87106-2058
(505) 238-1563
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/05/2019
Last updated
08/05/2019
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