Individual
ALISA ANN DAMHOLT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2600 YALE BLVD SE, ALBUQUERQUE, NM 87106-4383
(505) 994-7999
Mailing address
933 BRADBURY DR SE STE 2222, ALBUQUERQUE, NM 87106-4375
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
C-11264
NM
104100000X
Social Worker
M-10135
NM
Other
Enumeration date
12/16/2018
Last updated
06/08/2023
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