Individual
TAMARA K THIEDEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
1101 MEDICAL ARTS AVE NE BLDG 3, ALBUQUERQUE, NM 87102-2706
(505) 232-9803
Mailing address
1101 MEDICAL ARTS AVE NE BLDG 3, ALBUQUERQUE, NM 87102-2706
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
X-05436
NM
Other
Enumeration date
07/06/2006
Last updated
07/08/2007
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