Individual
LAUREN ROTOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1201 3RD ST NW, ALBUQUERQUE, NM 87102-1403
(505) 242-4399
Mailing address
1201 3RD ST NW, ALBUQUERQUE, NM 87102-1403
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902918055
—
NM
Enumeration date
08/24/2022
Last updated
08/24/2022
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