Individual
ELOIS M MCKINZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA MSW LISW
Contact information
Practice address
1390 E 20TH ST, FARMINGTON, NM 87401-9037
(505) 599-8535
(505) 599-8536
Mailing address
1390 E 20TH ST, FARMINGTON, NM 87401-9037
(505) 599-8535
(505) 599-8536
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
I-04892
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43683738
—
NM
Enumeration date
11/13/2006
Last updated
07/08/2007
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