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1867 Georgia St Ne Albuquerque NM 87110-5902 | |
| (505) 206-1430 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Social Worker |
| Location | 1867 Georgia St Ne, Albuquerque, New Mexico |
| Authorized Official Name and Position | Glorijana Wolfgang (OWNER/CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 5052061430 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1867 Georgia St Ne Albuquerque NM 87110-5902 Ph: (505) 206-1430 | 1867 Georgia St Ne Albuquerque NM 87110-5902 Ph: (505) 206-1430 |
| NPI Number | 1467299123 |
|---|---|
| Provider Enumeration Date | 07/10/2024 |
| Last Update Date | 12/13/2024 |
| Certification Date | 12/13/2024 |
| Medicare PECOS PAC ID | 8820537442 |
|---|---|
| Medicare Enrollment ID | O20240827004653 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467299123 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Glorijana Wolfgang |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750818993 PECOS PAC ID: 1557800174 Enrollment ID: I20240827004667 |
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