Individual
SUSAN TAVIZON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCSS WORKER
Contact information
Practice address
1007 N. POPE STREET, SILVER CITY, NM 88061
(575) 388-1511
(575) 542-2388
Mailing address
530 DEMOSS STREET, LORDSBURG, NM 88045
(575) 542-8384
(575) 542-2388
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/05/2015
Last updated
10/05/2015
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