| Doctor Name: | MS. CAROL WELLS |
| NPI Number: | 1063565596 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LISW |
| License Number: | I-3477 |
| Business Practice Address: | 205 Lund St. Taos, NM - 875716294 |
| Business Phone Number: | 5757702415 |
| Business Fax Number: | 5757583471 |
| Mailing Address: | Po Box 654, TAOS |
| State: | NM |
| Postal Code: | 875710654 |
| Phone Number: | 5757702415 |
| Fax Number: | 5757583471 |
| NPI Enumeration Date: | 01/19/2007 |
| NPI Last Update Date: | 08/08/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | I-3477 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |