Individual
HEIDI FENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
280 1ST ST BLDG 23, HOLLOMAN AFB, NM 88330-8273
(575) 572-2778
Mailing address
PO BOX 514, TUCUMCARI, NM 88401
(505) 461-8639
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-06306
NM
Other
Enumeration date
10/25/2006
Last updated
07/24/2023
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