Individual
FAITH MYRANDA TIPTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4201 CARLISLE BLVD NE, ALBUQUERQUE, NM 87107-4808
(505) 717-1332
Mailing address
4201 CARLISLE BLVD NE, ALBUQUERQUE, NM 87107-4808
(505) 717-1332
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SWB-2023-0329
NM
1041C0700X
Clinical Social Worker
SWB-2023-0329
NM
Other
Enumeration date
12/29/2020
Last updated
12/16/2024
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