Individual
MS. MARY ADRIENNE SIMONINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
1224 CISNEROS RD, EL PRADO, NM 87529
(505) 758-3477
Mailing address
PO BOX 3313, TAOS, NM 87571-3313
(505) 758-3477
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-3213
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000K7386
—
NM
Enumeration date
01/18/2007
Last updated
07/09/2007
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