Individual
MARIA I GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
575 S ALAMEDA BLVD, LAS CRUCES, NM 88005
(575) 528-6400
(575) 521-7199
Mailing address
385 CALLE DE ALEGRA, BLDG. A, LAS CRUCES, NM 88005-3423
(575) 526-1105
(575) 524-4266
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
M-07789
NM
1041C0700X
Clinical Social Worker
Primary
C-09965
NM
1041C0700X
Clinical Social Worker
X-09939
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02488027
—
NM
01
—
377434YRND
MEDICARE
NM
Enumeration date
07/15/2014
Last updated
08/28/2018
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