Individual
BAILEE OLIVIA VANANTWERP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4101 BARBARA LOOP SE STE C, RIO RANCHO, NM 87124-1011
(505) 933-1978
Mailing address
7510 MONTGOMERY BLVD NE STE 202, ALBUQUERQUE, NM 87109-1500
(505) 933-1978
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SWB-2025-1160
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
N0008167
—
NM
Enumeration date
11/20/2024
Last updated
11/12/2025
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