Individual
MS. JULIE RENE' PUGH-RIVETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
1001 W BROADWAY, SUITE D, FARMINGTON, NM 87401-5638
(505) 566-0338
(505) 327-7247
Mailing address
1001 W BROADWAY, SUITE D, FARMINGTON, NM 87401-5638
(505) 566-0338
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-06055
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
98320751
—
NM
Enumeration date
08/29/2007
Last updated
01/27/2011
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