Individual
JARED ROUNSVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LISW
Contact information
Practice address
4400 PRESIDENTIAL PL NE, SUITE C, ALBUQUERQUE, NM 87109-3442
(505) 345-3046
Mailing address
5732 CIBOLA DR NE, RIO RANCHO, NM 87144-5181
(505) 771-1467
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
I05764
NM
Other
Enumeration date
02/02/2007
Last updated
07/08/2007
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