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Individual

MICAH TERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3100 INDIAN SCHOOL RD NE, ALBUQUERQUE, NM 87106-1862
(505) 260-2040
Mailing address
3100 INDIAN SCHOOL RD NE, ALBUQUERQUE, NM 87106-1862
(505) 260-2040

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
M-12006
NM
1041S0200X
School Social Worker
Primary
409832
NM

Other

Enumeration date
08/18/2022
Last updated
08/18/2022
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