Organization
LIANA LOUGHEAD LISW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIANA A. LOUGHEAD LISW (OWNER)
(505) 261-1755
Entity
Organization
Contact information
Practice address
5712 OSUNA RD NE, ALBUQUERQUE, NM 87109-2566
(505) 261-1755
(505) 508-2584
Mailing address
5712 OSUNA RD NE, ALBUQUERQUE, NM 87109-2566
(505) 261-1755
(505) 508-2584
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-08489
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12619935
CAQH
NM
05
—
97633381
—
NM
Enumeration date
02/02/2016
Last updated
02/02/2016
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