Facts
- Status
- A
- Credential
- LMSW
- Type
- Individual
- Enumeration date
- 2023-04-18
- Last updated
- 2023-04-18
Specialties
Licenses
- License NM
- SWB-2022-1016
Location
- Practice location
- 826 ANTHONY DR
- City
- ANTHONY NM
- Postal code
- 880219317
- Phone
- 575-201-5135
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.