Organization
MELISSA HAGSTRUM LISW PHD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELISSA B. HAGSTRUM LISW, PHD (OWNER)
(505) 660-0403
Entity
Organization
Contact information
Practice address
901 W SAN MATEO RD, D4, SANTA FE, NM 87505-3981
(505) 660-0403
Mailing address
6 FRASCO RD, SANTA FE, NM 87508-8842
(505) 660-0403
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-08107
NM
Other
Enumeration date
03/06/2014
Last updated
03/06/2014
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