Individual
JEFFREY KOENIGSBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LISW
Contact information
Practice address
813 THRUPPS ST, LAS VEGAS, NM 87701-3493
(505) 670-7172
Mailing address
813 THRUPPS ST, LAS VEGAS, NM 87701-3493
(505) 670-7172
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1-08119
NM
Other
Enumeration date
01/14/2013
Last updated
01/14/2013
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