Individual
MRS. VIRGINIA A ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.I.S.W.
Contact information
Practice address
101 N 2ND ST, RATON, NM 87740-3803
(505) 445-7090
(505) 445-7663
Mailing address
101 N 2ND ST, RATON, NM 87740-3803
(505) 445-7090
(505) 445-7663
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
I-05743
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
58230882
—
NM
Enumeration date
07/21/2006
Last updated
07/09/2007
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