Individual
BRUCE BALTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LISW, DCSW
Contact information
Practice address
3417 CARLISLE BLVD. NE, ALBUQUERQUE, NM 87110-1648
(505) 227-3052
(505) 792-4057
Mailing address
PO BOX 67691, ALBUQUERQUE, NM 87193-7691
(505) 227-3052
(505) 792-4057
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-06300
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17502331
—
NM
Enumeration date
12/13/2006
Last updated
04/03/2012
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