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Individual

LETHA SUE OLMOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LISW

Contact information

Practice address
540 CHAMA ST. NE, ALBUQUERQUE, NM 87108
(505) 265-0753
(505) 268-5722
Mailing address
540 CHAMA ST NE, ALBUQUERQUE, NM 87108
(505) 265-0753
(505) 268-5722

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
X-05627
NM
104100000X
Social Worker
Primary
I-07273
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
36628271
NM
Enumeration date
08/14/2007
Last updated
10/22/2012
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