Individual
MR. KLYNN DAVID DONALDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LISW
Contact information
Practice address
3521 DEL REY BLVD, LAS CRUCES, NM 88012-7708
(505) 373-5057
(505) 373-5058
Mailing address
PO BOX 6036, LAS CRUCES, NM 88006-6036
(505) 373-5057
(505) 373-5058
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-04812
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01187520
—
NM
01
—
NM100802
VALUE OPTIONS NEW MEXICO
NM
Enumeration date
11/07/2006
Last updated
07/08/2007
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