Individual
MS. MICHELLE ANTOINETTE BRUCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
546 N. 10TH ST, FORT SUMNER, NM 88119-0349
(575) 355-2414
(575) 355-7894
Mailing address
PO BOX 349, FORT SUMNER, NM 88119-0349
(575) 355-2414
(575) 355-7894
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
X07076
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
S7012
—
NM
Enumeration date
08/12/2010
Last updated
08/08/2011
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