Individual
LISA DANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFPSW
Contact information
Practice address
808 FIR ST, T OR C, NM 87901-1724
(575) 937-2944
Mailing address
808 FIR ST, T OR C, NM 87901-1724
(575) 937-2944
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
2011
NM
Other
Enumeration date
07/09/2020
Last updated
07/09/2020
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