Individual
JOSE FRESQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, LISW/LCSW
Contact information
Practice address
4321 FULCRUM WAY NE STE B, RIO RANCHO, NM 87144-8410
(505) 205-6760
(505) 867-3514
Mailing address
4321 FULCRUM WAY NE STE B, RIO RANCHO, NM 87144-8410
(505) 205-6760
(505) 867-3514
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0005
NM
Other
Enumeration date
12/03/2015
Last updated
12/03/2015
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