Individual
GEORGIA QUINTANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LBSW, MSW
Contact information
Practice address
605 LETRADO ST, SANTA FE, NM 87505-4146
(505) 476-2642
(505) 476-2695
Mailing address
605 LETRADO ST, SANTA FE, NM 87505-4146
(505) 476-2642
(505) 476-2695
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
B05217
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
856000565
NM DEPARTMENT OF HEALTH
NM
Enumeration date
04/28/2014
Last updated
04/28/2014
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