Individual
LUCIA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6009 HANNETT AVE NE, ALBUQUERQUE, NM 87110-5914
(505) 385-1994
Mailing address
6009 HANNETT AVE NE, ALBUQUERQUE, NM 87110-5914
(505) 385-1994
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/19/2012
Last updated
10/19/2012
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