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Individual

RAVEN MONDRAGON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
535 S MIRANDA ST, LAS CRUCES, NM 88005-2823
(575) 647-2800
(575) 647-2898
Mailing address
385 CALLE DE ALEGRA BLDG A, LAS CRUCES, NM 88005-3423
(575) 526-1105
(575) 524-4266

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SWB-2024-1201
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
N0011336
NM
Enumeration date
02/07/2025
Last updated
02/03/2026
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