Individual
TAMI CARPENTER-ROEBUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
313 W APACHE ST, FARMINGTON, NM 87401-5835
(505) 325-5321
Mailing address
313 W APACHE ST, FARMINGTON, NM 87401-5835
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
M-07281
NM
1041C0700X
Clinical Social Worker
Primary
I-07974
NM
1041C0700X
Clinical Social Worker
X-07470
NM
Other
Enumeration date
07/06/2009
Last updated
11/02/2012
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