Individual
MRS. MARY JO RANELLS BACA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW, MPH
Contact information
Practice address
2112 MAIN ST NE, SUITE A, LOS LUNAS, NM 87031-6353
(505) 865-6176
(505) 865-3268
Mailing address
617 EDITH BLVD NE, #5, ALBUQUERQUE, NM 87102-2570
(505) 239-9369
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
M-06042
NM
Other
Enumeration date
03/27/2007
Last updated
07/08/2007
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