Provider Demographics
NPI:1891538377
Name:CHAVEZ-PAULETTE, LETICIA (CCSW, CPSW)
Entity type:Individual
Prefix:
First Name:LETICIA
Middle Name:
Last Name:CHAVEZ-PAULETTE
Suffix:
Gender:F
Credentials:CCSW, CPSW
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 53516
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87153-3516
Mailing Address - Country:US
Mailing Address - Phone:505-267-5090
Mailing Address - Fax:877-986-9227
Practice Address - Street 1:9910 INDIAN SCHOOL RD NE # 208
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-2971
Practice Address - Country:US
Practice Address - Phone:505-267-5090
Practice Address - Fax:877-986-9227
Is Sole Proprietor?:No
Enumeration Date:2024-06-13
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM765175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist