Individual
MARIANNE VIVICA MEADOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8600 ACADEMY RD NE, ALBUQUERQUE, NM 87111-1107
(505) 821-3628
(505) 856-7103
Mailing address
8600 ACADEMY RD NE, ALBUQUERQUE, NM 87111-1107
(505) 821-3628
(505) 856-7103
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-06790
NM
Other
Enumeration date
07/23/2010
Last updated
07/23/2010
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