Individual
DIANA J MACIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
6400 UPTOWN BLVD NE, ALBUQUERQUE, NM 87110-4202
(505) 880-3700
Mailing address
1483 15TH ST SE, RIO RANCHO, NM 87124-3528
(505) 615-9215
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041S0200X
School Social Worker
Primary
SWB-2022-0897
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0
—
NM
Enumeration date
04/08/2021
Last updated
12/07/2022
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