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1447401195
IVAN MARIE ROQUE
ALBUQUERQUE, NM
NPI
1447401195
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NM C-09696)
Enumeration Date
2008-09-30
Last Update Date
2020-11-09
Business Address
IVAN MARIE ROQUE LCSW
707 BROADWAY BLVD NE STE 500
ALBUQUERQUE, NM 87102-2367
Phone number: 505-268-0701
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Mailing Address
IVAN MARIE ROQUE LCSW
PO BOX 1637
OWENSBORO, KY 42302-1637
Phone number: 270-689-6500
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