| NPI | 1457987737 |
|---|---|
| Former Name | MARLENE TABITHA CANTU |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NM SWB-2022-0059) |
| Additional Taxonomies | 104100000X Social Worker |
| 172V00000X Community Health Worker | |
| Enumeration Date | 2020-03-18 |
| Last Update Date | 2023-09-13 |