Individual
MS. GEORGIA LEROY HAYNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
3031 HOT SPRINGS BLVD, LAS VEGAS, NM 87701-4288
(505) 425-9464
(505) 425-8420
Mailing address
111 N RAILROAD AVE, ESPANOLA, NM 87532-2627
(505) 753-7218
(505) 753-5815
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
X06369
NM
Other
Enumeration date
06/04/2009
Last updated
06/04/2009
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