Individual
PAMELA ANNE RISLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
127 EASTGATE DR, SUITE 206, LOS ALAMOS, NM 87544-3300
(505) 662-5717
(505) 662-5717
Mailing address
48 LA PALOMA DR, LOS ALAMOS, NM 87544-3434
(505) 672-9710
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I 05566
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00JN33
MESA BLUE CROSS BLUE SHI
NM
01
—
550010004361
PACIFICARE BEH HEALTH
NM
05
—
95321781
—
NM
Enumeration date
04/13/2007
Last updated
07/08/2007
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