Provider Demographics
NPI:1093466856
Name:CHIQUITO, CECELIA (CSW)
Entity Type:Individual
Prefix:
First Name:CECELIA
Middle Name:
Last Name:CHIQUITO
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 638
Mailing Address - Street 2:
Mailing Address - City:CUBA
Mailing Address - State:NM
Mailing Address - Zip Code:87013-0638
Mailing Address - Country:US
Mailing Address - Phone:575-289-3291
Mailing Address - Fax:
Practice Address - Street 1:6349 US HIGHWAY 550
Practice Address - Street 2:
Practice Address - City:CUBA
Practice Address - State:NM
Practice Address - Zip Code:87013-6032
Practice Address - Country:US
Practice Address - Phone:575-289-3291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-13
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator