Individual
JESSICA STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 LASER RD NE, RIO RANCHO, NM 87124-4517
(505) 962-1242
Mailing address
500 LASER RD NE, RIO RANCHO, NM 87124-4517
(505) 962-1242
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
SWB-2023-0449
NM
1041S0200X
School Social Worker
Primary
X-11626
NM
Other
Enumeration date
08/10/2020
Last updated
06/03/2024
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