Individual
JAN LOEB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW (PROVISIONAL)
Contact information
Practice address
540 CHAMA ST NE, ALBUQUERQUE, NM 87108-3594
(505) 265-0753
Mailing address
7027 MONTGOMERY BLVD NE STE F, ALBUQUERQUE, NM 87109-1529
(505) 880-0100
(505) 880-0102
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
X-05935
NM
Other
Enumeration date
09/11/2007
Last updated
09/09/2008
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