Individual
MR. JAN PHILIP STANLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSSW
Contact information
Practice address
1 TANO ESCONDIDO, SANTA FE, NM 87506-7512
(505) 983-2277
(505) 476-2320
Mailing address
#1 TANO ESCONDIDO, SANTA FE, NM 87506
(505) 983-2277
(505) 476-2320
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-1927
NM
Other
Enumeration date
10/01/2009
Last updated
10/01/2009
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