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Individual

MS. ANGELICA VILLICANA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LISW

Contact information

Practice address
1320 S. SOLANO, LAS CRUCES, NM 88001
(575) 527-7900
(575) 571-4872
Mailing address
1320 S. SOLANO, LAS CRUCES, NM 88001
(575) 527-7900
(575) 571-4872

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
M-06894
NM
1041C0700X
Clinical Social Worker
Primary
1-08104
NM
1041C0700X
Clinical Social Worker
I-08104
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
18677037
NM
Enumeration date
06/10/2009
Last updated
03/10/2014
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