Individual
MISS LURA WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
1990E LOHMAN AVE 204, LAS CRUCES, NM 88001-3172
(575) 525-0304
(575) 524-4813
Mailing address
1300G EL PASEO RD 201, LAS CRUCES, NM 88001-6024
(575) 525-0304
(575) 524-4813
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-3362
NM
Other
Enumeration date
11/16/2006
Last updated
09/10/2015
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