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Organization

A SHARED PATH LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHERRU LEBEZNICK BROWN LCSW (CLINICAL DIRECTOR)
(505) 730-6735
Entity
Organization

Contact information

Practice address
4011 BARBARA LOOP SE, SUITE 107, RIO RANCHO, NM 87124-1039
(505) 730-6735
Mailing address
4608 SAM BRATTON AVE NW, ALBUQUERQUE, NM 87114-5333
(505) 730-6735

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C-07730
NM

Other

Enumeration date
01/26/2017
Last updated
01/26/2017
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