Individual
MS. TRACEY M DUNNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
1501 SAN PEDRO DR SE, ALBUQUERQUE, NM 87108-5153
(505) 265-1711
Mailing address
11201 ANAHEIM AVE NE, ALBUQUERQUE, NM 87122-1550
(505) 828-9421
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-07148
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
I-07148
STATE LICENSE
NM
01
—
M-2720
SOCIAL WORK LICENSE #
NM
Enumeration date
08/16/2006
Last updated
12/04/2014
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