Individual
MS. ELIA JACQUELINE FLORES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSW
Contact information
Practice address
1325 WASHINGTON ST, ANTHONY, NM 88021-8846
(575) 882-6101
Mailing address
1325 WASHINGTON ST, ANTHONY, NM 88021-8846
(575) 882-6101
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0109051
NM
1041C0700X
Clinical Social Worker
Primary
SWB-2022-0850
NM
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
VNM30451NI
—
NM
Enumeration date
12/18/2007
Last updated
04/05/2023
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