Provider Demographics
NPI:1346453289
Name:SANDOVAL, MARIA CATARINA (LISW,LCSW)
Entity Type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:CATARINA
Last Name:SANDOVAL
Suffix:
Gender:F
Credentials:LISW,LCSW
Other - Prefix:MS
Other - First Name:KATIE
Other - Middle Name:M
Other - Last Name:SANDOVAL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LISW,LCSW
Mailing Address - Street 1:5720 RIO ARRIBA RD NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87144-6420
Mailing Address - Country:US
Mailing Address - Phone:505-328-9580
Mailing Address - Fax:505-797-0648
Practice Address - Street 1:5720 RIO ARRIBA RD NE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87144-6420
Practice Address - Country:US
Practice Address - Phone:505-328-9580
Practice Address - Fax:505-797-0648
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI14721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical