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1114469756
BERTHA DE VRIES
ALBUQUERQUE, NM
NPI
1114469756
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NM C-09224)
Enumeration Date
2016-11-14
Last Update Date
2016-11-14
Business Address
-- BERTHA DE VRIES
201 CEDAR ST SE STE 820
ALBUQUERQUE, NM 87106-4912
Phone number: 505-841-1434
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Mailing Address
-- BERTHA DE VRIES
PO BOX 26666 PHS PROVIDER ENROLLMENT
ALBUQUERQUE, NM 87125-6666
Phone number: 505-923-6770
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