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Organization (NPI-2)
Active
Social Worker
Provider Information
- NPI Number
1770937732- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 100 E AZTEC AVE, GALLUP, NM, 873016256
- Phone
- (505) 863-7472
- Fax
- (505) 863-7472
Specialties & Taxonomies
Social Worker
Primary License: NM #I-3118