Individual
GINA CORDOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
105 BERTHA RD STE B, TAOS, NM 87571-7148
(575) 758-4297
Mailing address
4180 STATE ROAD 68, RANCHOS DE TAOS, NM 87557-8850
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
03/14/2024
Last updated
05/28/2024
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