| Doctor Name: | JODIE L HART |
| NPI Number: | 1093049785 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMSW |
| License Number: | M-06061 |
| Business Practice Address: | 608 Bledsoe Rd Nw Los Ranchos, NM - 871076219 |
| Business Phone Number: | 5054508007 |
| Business Fax Number: | |
| Mailing Address: | 3326 Linda Vista Ave Se, ALBUQUERQUE |
| State: | NM |
| Postal Code: | 871061514 |
| Phone Number: | 5054508007 |
| Fax Number: | 5052688949 |
| NPI Enumeration Date: | 09/28/2009 |
| NPI Last Update Date: | 02/01/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | M-06061 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| 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 |