Individual
MARILOU RENIE TAGLIATELA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
101 N 2ND ST, RATON, NM 87740-3803
(505) 445-7090
Mailing address
5740 HOUSMAN AVE, PUEBLO, CO 81004-9708
(719) 214-2568
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
M-05797
NM
Other
Enumeration date
04/17/2006
Last updated
07/08/2007
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