| Melissa Hagstrum Lisw Phd | |
|
901 W San Mateo Rd D4 Santa Fe NM 87505-3981 | |
| (505) 660-0403 | |
| Not Available |
| Full Name | Melissa Hagstrum Lisw Phd |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 901 W San Mateo Rd, Santa Fe, New Mexico |
| Authorized Official Name and Position | Melissa B. Hagstrum (OWNER) |
| Authorized Official Contact | 5056600403 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Melissa Hagstrum Lisw Phd 6 Frasco Rd Santa Fe NM 87508-8842 Ph: (505) 660-0403 | Melissa Hagstrum Lisw Phd 901 W San Mateo Rd D4 Santa Fe NM 87505-3981 Ph: (505) 660-0403 |
| NPI Number | 1639595291 |
|---|---|
| Provider Enumeration Date | 03/06/2014 |
| Last Update Date | 03/06/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639595291 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | I-08107 (New Mexico) | Primary |
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