Individual
MRS. MICHELLE K BANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
1218 GRIEGOS RD NW, ALBUQUERQUE, NM 87107-3752
(505) 345-8471
Mailing address
1108 GRANADA HILLS CT NE, ALBUQUERQUE, NM 87123-1837
(505) 323-1790
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-05090
NM
Other
Enumeration date
05/08/2007
Last updated
07/08/2007
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