Individual
MS. LIANA ALEXIS LOUGHEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5712 OSUNA RD. NE, ALBUQUERQUE, NM 87109
(505) 508-1470
(505) 508-2584
Mailing address
5712 OSUNA RD. NE, ALBUQUERQUE, NM 87109
(505) 261-1755
(505) 508-2584
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
M-07454
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M-07454
NM STATE LICENSE
NM
Enumeration date
10/18/2010
Last updated
09/24/2015
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