Individual
THEODORE RAY NIETO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
1320 S SOLANO DR, LAS CRUCES, NM 88001-3758
(575) 522-4004
(575) 522-9017
Mailing address
1320 S SOLANO DR, LAS CRUCES, NM 88001-3758
(575) 522-4004
(575) 522-9017
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
M-07852
NM
1041C0700X
Clinical Social Worker
X-07410
NM
Other
Enumeration date
08/24/2009
Last updated
01/11/2012
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