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Individual

MS. CAROL THEODOR MACHENDRIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LISW

Contact information

Practice address
125 E PALACE AVE, SUITE 44, SANTA FE, NM 87501-2085
(505) 984-1687
(505) 983-0871
Mailing address
7644 OLD SANTA FE TRL, SANTA FE, NM 87505-9359
(505) 984-1687
(505) 983-0871

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-0115
NM

Other

Enumeration date
01/06/2007
Last updated
07/08/2007
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