Individual
JENNIFER MADRID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
10052 COORS BLVD NW, ALBUQUERQUE, NM 87114-4020
(505) 459-0025
Mailing address
10052 COORS BLVD NW, ALBUQUERQUE, NM 87114-4020
(505) 459-0025
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C-08984
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
83758101
—
NM
Enumeration date
09/09/2009
Last updated
11/11/2024
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