Individual
STEPHANIE CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6 CALLE MEDICO STE 1, SANTA FE, NM 87505-4761
(505) 733-0003
Mailing address
PO BOX 94508, ALBUQUERQUE, NM 87199-4508
(505) 273-4668
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/05/2022
Last updated
04/05/2022
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