Individual
IVONNE RILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1200 HIGHWAY 60, SOCORRO, NM 87801
(575) 835-2444
Mailing address
423 MELODY LN S, SOCORRO, NM 87801-5029
(505) 363-9606
(000) 000-0000
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
M-09956
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
22623213
—
NM
Enumeration date
08/23/2010
Last updated
06/18/2018
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