Individual
JESSICA MONIQUE LUCERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3 MORA VALLEY CLINIC RD, MORA, NM 87732-2202
(575) 387-5069
(575) 387-9006
Mailing address
PO BOX 209, MORA, NM 87732-0209
(575) 387-5069
(575) 387-9006
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C11944
NM
Other
Enumeration date
01/03/2022
Last updated
01/03/2022
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