Individual
THERESA A PABLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
US HWY 491 N, SHIPROCK, NM 87420
(505) 368-7450
(505) 368-7454
Mailing address
PO BOX 160, SHIPROCK, NM 87420-0160
(505) 368-7450
(505) 368-7454
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
M-11671
NM
Other
Enumeration date
12/14/2016
Last updated
09/30/2021
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