Individual
DR. WANDA K. WHITTLESEY-JEROME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LMSW, PHD
Contact information
Practice address
10138 BOSQUE CIR NW, ALBUQUERQUE, NM 87114-8827
(505) 414-8467
(505) 407-0075
Mailing address
1033 W MEADOWLARK LN, CORRALES, NM 87048-9688
(505) 610-6808
(505) 896-6942
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
M-04933
NM
Other
Enumeration date
05/25/2017
Last updated
05/25/2017
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