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Individual

MS. MICHELLE RENAUD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
807 W APACHE ST, FARMINGTON, NM 87401-5527
(505) 325-5358
(505) 326-3085
Mailing address
807 W APACHE ST, FARMINGTON, NM 87401-5527
(505) 325-5358
(505) 326-3085

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
104100000X
Social Worker
Primary
C-09327
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1154389
NM
Enumeration date
05/19/2010
Last updated
05/13/2016
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