Individual
MR. VIVIAN HERRERA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LBSW
Contact information
Practice address
6621 DONIPHAN DR STE G, CANUTILLO, TX 79835-5005
(915) 877-5100
(915) 877-5107
Mailing address
6621 DONIPHAN DR STE G, CANUTILLO, TX 79835-5005
(915) 877-5100
(915) 877-5107
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
B-3779
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
VNM30451NO
—
NM
Enumeration date
04/11/2008
Last updated
04/11/2008
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