Individual
ALYSSA WENNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
700 BOARDMAN DR, GALLUP, NM 87301-4707
(505) 721-1800
Mailing address
PO BOX 1318, GALLUP, NM 87305-1318
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
SWB-2023-0798
NM
Other
Enumeration date
02/06/2025
Last updated
02/06/2025
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