Individual
CLARENCE AARON ENOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCMSW
Contact information
Practice address
216 W MALONEY AVE, GALLUP, NM 87301-5214
(505) 870-1483
Mailing address
PO BOX 3809, GALLUP, NM 87305-3809
(505) 863-3377
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
M-07770
NM
1041C0700X
Clinical Social Worker
Primary
X-10430
NM
Other
Enumeration date
08/12/2013
Last updated
04/13/2018
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