Provider Demographics
NPI:1235472382
Name:HARRISON-SANCHEZ, JENNIFER MARIE (LMSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MARIE
Last Name:HARRISON-SANCHEZ
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 1:61221 INDIAN SCHOOL RD NE STE 103
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-4165
Mailing Address - Country:US
Mailing Address - Phone:505-345-5529
Mailing Address - Fax:505-345-2211
Practice Address - Street 1:6121 INDIAN SCHOOL RD NE STE 103
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-4165
Practice Address - Country:US
Practice Address - Phone:505-345-5529
Practice Address - Fax:505-345-2211
Is Sole Proprietor?:No
Enumeration Date:2013-03-27
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM-08234104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker