Provider Demographics
NPI:1053714857
Name:GARCIA-VALENZUELA, LAURA (LMSW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:GARCIA-VALENZUELA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 ABAJO RD SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-5105
Mailing Address - Country:US
Mailing Address - Phone:505-903-1700
Mailing Address - Fax:
Practice Address - Street 1:340 ABAJO RD SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-5105
Practice Address - Country:US
Practice Address - Phone:505-903-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-07
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMX-088371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical