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Individual

ALLISON BENTON GOSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LISW

Contact information

Practice address
1400 CARLISLE BLVD NE, SUITE A, ALBUQUERQUE, NM 87110-5667
(505) 266-2997
(505) 266-3063
Mailing address
1400 CARLISLE BLVD NE, SUITE A, ALBUQUERQUE, NM 87110-5667
(505) 266-2997
(505) 266-3063

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-2140
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
I-2140
LISW LICENSE NO.
NM
05
Q0481
NM
Enumeration date
11/20/2006
Last updated
03/27/2009
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