Individual
MS. JACKIE LYNN ORDAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
6621 DONIPHAN DR STE G, CANUTILLO, TX 79835-5005
(915) 877-5100
(915) 877-5107
Mailing address
6621 DONIPHAN DR STE G, CANUTILLO, TX 79835-5005
(915) 877-5100
(915) 877-5107
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
X-05978
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
VNM30451NI
—
NM
Enumeration date
08/22/2007
Last updated
08/22/2007
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