Individual
SUSAN HACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1001 W BROADWAY, FARMINGTON, NM 87401-5638
(804) 731-4090
Mailing address
1001 W BROADWAY, FARMINGTON, NM 87401-5638
(804) 731-4090
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
07/15/2019
Last updated
09/29/2022
About Stedi
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