Individual
TILDA KIMURA BULANON-CHAVEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1501 SAN PEDRO DR SE, ALBUQUERQUE, NM 87108-5153
(505) 265-1711
Mailing address
101 WHITE HORSE LN, CORRALES, NM 87048-8753
(505) 897-3754
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-4196
NM
Other
Enumeration date
08/15/2006
Last updated
07/08/2007
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