Individual
CHERYL LYNNE BLOSSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
2420 JUAN TABO BLVD NE, ALBUQUERQUE, NM 87112-1818
(505) 292-2237
(505) 830-6527
Mailing address
3409-D LAFAYETTE DR. NE, ALBUQUERQUE, NM 87107
(505) 250-6723
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-3495
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
51786826
—
NM
Enumeration date
12/05/2006
Last updated
04/30/2010
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