Doctor Name: | KATHLEEN MARY SANSING |
NPI Number: | 1295914455 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LISW |
License Number: | I-04973 |
Business Practice Address: | 1607 W Aztec Blvd Aztec, NM - 874101805 |
Business Phone Number: | 5053346102 |
Business Fax Number: | 5055994385 |
Mailing Address: | 1607 W Aztec Blvd, AZTEC |
State: | NM |
Postal Code: | 874101805 |
Phone Number: | 5053346102 |
Fax Number: | 5055994385 |
NPI Enumeration Date: | 10/24/2007 |
NPI Last Update Date: | 10/24/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041S0200X |
License Number: | I-04973 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | School |
Taxonomy Definition: |