Individual
ILSE AIMEE CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
826 ANTHONY DR, ANTHONY, NM 88021-9317
(575) 201-5135
(575) 449-4052
Mailing address
385 CALLE DE ALEGRA STE A, LAS CRUCES, NM 88005-3423
(575) 526-1105
(575) 524-4266
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
X-12088
NM
171M00000X
Case Manager/Care Coordinator
—
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
46039767
—
NM
Enumeration date
06/16/2021
Last updated
02/09/2022
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