Individual
MALISA MASSINGALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LBSW
Contact information
Practice address
1600 THORPE RD, LAS CRUCES, NM 88012-9776
(575) 382-9292
(575) 392-2061
Mailing address
PO BOX 370, HATCH, NM 87937-0370
(575) 267-3088
(575) 267-1747
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
B-05945
NM
Other
Enumeration date
05/15/2008
Last updated
05/15/2008
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