Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | I-06454 | NM |
NPI | 1003028937 |
---|---|
Provider Name | Ms. Judith Sandra Schneider |
First Address | Abiquiu, NM 87510-0618 |
Second Address | Abiquiu, NM 87510-0618 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2007 |
Last Update Date | 08/07/2007 |