Individual
BOBBY S HEARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
110 E MESCALERO RD, ROSWELL, NM 88201-6542
(575) 623-1480
(575) 622-3325
Mailing address
3978 S SPRING LOOP, ROSWELL, NM 88203-9625
(575) 626-2241
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0111741
NM
1041C0700X
Clinical Social Worker
Primary
C-08189
NM
1041C0700X
Clinical Social Worker
I-08189
NM
Other
Enumeration date
08/18/2009
Last updated
11/08/2018
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