Individual
CELESTE BACA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
405 HUNTER ST, ESPANOLA, NM 87532-2656
(505) 753-2254
Mailing address
405 HUNTER ST, ESPANOLA, NM 87532-2656
(505) 753-2254
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
11177
NM
Other
Enumeration date
08/14/2020
Last updated
08/14/2020
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