Individual
BEVERLY TAMANINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
208 1/2 E HILL AVE, GALLUP, NM 87301-6153
(505) 863-1930
Mailing address
208 1/2 E HILL AVE, GALLUP, NM 87301-6153
(505) 863-1930
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
X-07980
NM
Other
Enumeration date
10/17/2012
Last updated
04/22/2013
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