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Individual

JENNELLE DAWN HINDASH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
3855 FOOTHILLS RD STE C, LAS CRUCES, NM 88011-4772
(575) 496-7762
Mailing address
3855 FOOTHILLS RD STE C, LAS CRUCES, NM 88011-4772
(575) 386-5254

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
C-06649
NM
104100000X
Social Worker
M-05761
NM
1041C0700X
Clinical Social Worker
Primary
C-06649
NM
1041C0700X
Clinical Social Worker

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
17831237
NM
05
41676238
NM
Enumeration date
03/01/2007
Last updated
01/18/2024
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