Organization
OR FACTOR
Active
Organization
OR FACTOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY SHANNON BYRNE LCSW (OWNER)
(575) 420-7336
Entity
Organization
Contact information
Practice address
400 N PENNSYLVANIA AVE STE 670C, ROSWELL, NM 88201-4755
(575) 420-7336
(575) 627-5721
Mailing address
400 N PENNSYLVANIA AVE STE 670C, ROSWELL, NM 88201-4755
(575) 623-7336
(575) 623-7337
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
12/02/2016
Last updated
07/18/2024
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