Individual
AMANDA ASHLEY CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
901 E 19TH ST, ROSWELL, NM 88201-7533
(505) 702-9080
Mailing address
2613 BEVERLY AVE, ROSWELL, NM 88201-8623
(575) 749-9524
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SWB-2025-0814
NM
224Z00000X
Occupational Therapy Assistant
Primary
OTA2852
NM
Other
Enumeration date
06/12/2019
Last updated
01/27/2026
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