Doctor Name: | MRS. JANET MARIE KRUSICK |
NPI Number: | 1134448061 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMSW |
License Number: | M-07242 |
Business Practice Address: | 735 Don Pasqual Rd Nw Los Lunas, NM - 870318493 |
Business Phone Number: | 5058653350 |
Business Fax Number: | |
Mailing Address: | 22 Desert Mountain Rd, PLACITAS |
State: | NM |
Postal Code: | 870439552 |
Phone Number: | 5053795689 |
Fax Number: | |
NPI Enumeration Date: | 05/17/2010 |
NPI Last Update Date: | 05/17/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | M-07242 |
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 |