Doctor Name: | CAROL ANN ARCHULETA |
NPI Number: | 1629324124 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMSW, LSAA |
License Number: | M-07590 |
Business Practice Address: | 218 E Chuska St Aztec, NM - 874102113 |
Business Phone Number: | 5053337042 |
Business Fax Number: | |
Mailing Address: | 218 E Chuska St, AZTEC |
State: | NM |
Postal Code: | 874102113 |
Phone Number: | 5053337042 |
Fax Number: | |
NPI Enumeration Date: | 08/02/2012 |
NPI Last Update Date: | 08/02/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | M-07590 |
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 |