Organization
JANELLE CASSIDY, LCSW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANELLE M. CASSIDY LCSW (LCSW)
(575) 779-2031
Entity
Organization
Contact information
Practice address
310 B RIO LUCERO RD, EL PRADO, NM 87529
(575) 779-2031
Mailing address
66 MAESTAS RD, RANCHOS DE TAOS, NM 87557-9780
(575) 779-2031
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C-10004
NM
Other
Enumeration date
03/21/2018
Last updated
03/21/2018
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