Individual
MRS. TARA ELDRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4730 BECKNER RD, SANTA FE, NM 87507-3691
(505) 757-4601
Mailing address
6645 VOOSCANE AVE, COCHITI LAKE, NM 87083-6003
(505) 474-3095
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C-06429
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35074728
—
NM
Enumeration date
05/14/2007
Last updated
07/29/2024
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