Provider Demographics
NPI:1134298912
Name:CHARWOOD, RICKIE MARIE (CASE MANAGER)
Entity Type:Individual
Prefix:MRS
First Name:RICKIE
Middle Name:MARIE
Last Name:CHARWOOD
Suffix:
Gender:F
Credentials:CASE MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 JARAMILLO RD
Mailing Address - Street 2:
Mailing Address - City:TAOS
Mailing Address - State:NM
Mailing Address - Zip Code:87571-6590
Mailing Address - Country:US
Mailing Address - Phone:505-613-2636
Mailing Address - Fax:
Practice Address - Street 1:413 SIPAPU # 6952
Practice Address - Street 2:
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571-6489
Practice Address - Country:US
Practice Address - Phone:505-758-5857
Practice Address - Fax:505-758-2832
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist