Individual
JONATHAN BASKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
707 BROADWAY BLVD NE, ALBUQUERQUE, NM 87102-2360
(505) 267-0701
Mailing address
405 GREG AVE, SANTA FE, NM 87501-1663
(608) 909-1459
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
130589-121
WI
1041C0700X
Clinical Social Worker
9370-123
WI
1041C0700X
Clinical Social Worker
Primary
C-11693
NM
Other
Enumeration date
01/04/2018
Last updated
07/21/2024
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