Individual
JT CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LISW
Contact information
Practice address
2132A CENTRAL AVE SE # 249, ALBUQUERQUE, NM 87106-4083
(505) 259-7769
Mailing address
2132A CENTRAL AVE SE # 249, ALBUQUERQUE, NM 87106-4083
(505) 259-7769
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-04891
NM
Other
Enumeration date
07/10/2006
Last updated
07/08/2007
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