Individual
STEFANIE CORRAL-ENRIQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2600 MARBLE NE BUILDING 2, ALBUQUERQUE, NM 87131-2360
(505) 272-2190
(505) 272-3466
Mailing address
707 BROADWAY BLVD NE, ALBUQUERQUE, NM 87102-2360
(505) 345-8471
(505) 342-5450
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
NM
1041S0200X
School Social Worker
—
NM
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
NM
Other
Enumeration date
12/20/2017
Last updated
08/27/2020
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