Individual
LAURA E EDIMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
200 CENTER AVE, MORIARTY, NM 87035
(505) 832-5817
(505) 328-1354
Mailing address
P.O. BOX 2000, 200 CENTER AVE, MORIARTY, NM 87035
(505) 832-5817
(505) 328-1354
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
X-07066
NM
Other
Enumeration date
09/08/2009
Last updated
09/28/2010
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