Individual
SUSAN MARIE CHACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LISW
Contact information
Practice address
2040 S PACHECO ST, SANTA FE, NM 87505-5472
(505) 476-8860
Mailing address
12 BONITO CT, SANTA FE, NM 87508-8311
(505) 476-8860
(505) 476-8896
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
I-3132
NM
Other
Enumeration date
05/15/2007
Last updated
07/08/2007
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