Individual
DR. VIRGINIA LEE BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
1001 W BROADWAY STE D, BEHAVIORAL HEALTH DEPT., FARMINGTON, NM 87401-5638
(505) 566-0317
(505) 327-7247
Mailing address
1001 W BROADWAY STE D, BEHAVIORAL HEALTH DEPT., FARMINGTON, NM 87401-5638
(505) 566-0317
(505) 327-7247
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-06004
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
644452
AHCCCS
AZ
05
—
K5222
—
NM
Enumeration date
01/06/2006
Last updated
07/08/2007
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