Individual
SALLY J. WARNICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.I.S.W.
Contact information
Practice address
NORTHSTAR PLAZA STATE HWY 522, SUITE 67A, EL PRADO, NM 87529
(505) 779-0738
Mailing address
PO BOX 2629, TAOS, NM 87571-2629
(505) 779-0738
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C-4486
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00JP22
BCBS OF NM
NM
01
—
047127
VALUE OPTIONS MENTAL HEAL
NM
05
—
59635533
—
NM
Enumeration date
11/03/2006
Last updated
03/14/2017
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