Individual
MR. DANIELRAY MOISES BLEA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
914 N CANAL ST, CARLSBAD, NM 88220-5110
(575) 885-4836
Mailing address
914 N CANAL ST, CARLSBAD, NM 88220-5110
(755) 815-8692
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SWB-2024-1066
NM
Other
Enumeration date
08/08/2019
Last updated
11/11/2024
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