Individual
MR. ANTONIO MARTIN GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SW
Contact information
Practice address
1300 CAMINO SIERRA VIS # 125, SANTA FE, NM 87505-1007
(505) 467-2504
(505) 467-2646
Mailing address
732 MONTEZ ST, SANTA FE, NM 87501-3752
(505) 467-3007
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
M-2120
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M-2120
LMSW
NM
Enumeration date
12/07/2007
Last updated
12/07/2007
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