Individual
DANELLE BACA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
700 FRIEDMAN AVE, LAS VEGAS, NM 87701-4231
(505) 454-5100
Mailing address
700 FRIEDMAN AVE, LAS VEGAS, NM 87701-4231
(505) 454-5100
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
M05392
NM
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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