Individual
GUS CARRILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S.W.
Contact information
Practice address
4036 RAYADO PL NW, ALBUQUERQUE, NM 87114-5538
(505) 362-3378
Mailing address
4036 RAYADO PL NW, ALBUQUERQUE, NM 87114-5538
(505) 362-3378
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
M-09587
NM
Other
Enumeration date
06/10/2016
Last updated
10/31/2016
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