Organization Name: | SALLY JO WARNICK, LISW PSYCHOTHERAPY PRACTICE |
NPI Number: | 1851774426 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SALLY JO WARNICK (THERAPIST) |
Mailing Address: | 4155 State Road 68 Unit 6 Ranchos De Taos |
State: | NM US |
Postal Code: | 87557 |
Phone Number: | 5757767432 |
Fax Number: | |
NPI Enumeration Date: | 07/01/2015 |
NPI Last Update Date: | 10/14/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | I-4486 |
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 |