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Individual

MS. CAROL ANN HEREDIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
2025 E AZTEC AVE, GALLUP, NM 87301-4803
(505) 863-3828
(505) 443-8345
Mailing address
2025 E AZTEC AVE, GALLUP, NM 87301-4803
(505) 863-3828
(505) 443-8345

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
M-08084
NM

Other

Enumeration date
12/06/2012
Last updated
01/13/2026
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