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Individual

FLETCHER BROOK WOOD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
6014 PRINCESS JEANNE AVE NE, ALBUQUERQUE, NM 87110-5921
(505) 908-6013
Mailing address
800 BRADBURY DR SE STE 116, ALBUQUERQUE, NM 87106-4310
(505) 272-1476

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
1041C0700X
Clinical Social Worker
Primary
C-10597
NM
1041C0700X
Clinical Social Worker
NM

Other

Enumeration date
01/20/2012
Last updated
10/30/2024
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