Individual
ANNA R KRUTSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1001 W BROADWAY, SUITE D, FARMINGTON, NM 87401-5638
(505) 325-0238
Mailing address
1001 W BROADWAY, SUITE D, FARMINGTON, NM 87401-5638
(505) 325-0238
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C-08509
NM
1041C0700X
Clinical Social Worker
X-08302
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1649402991
OPTUMHEALTH
NM
01
—
4902099
CIGNA BH
NM
05
—
50876544
—
NM
Enumeration date
08/20/2009
Last updated
02/11/2019
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