Organization
GINA SIMON LISW PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINA SIMON LISW (OWNER)
(505) 249-8764
Entity
Organization
Contact information
Practice address
2729 MESILLA ST NE, ALBUQUERQUE, NM 87110-3539
(505) 249-8764
Mailing address
2729 MESILLA ST NE, ALBUQUERQUE, NM 87110-3539
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I3207
NM
Other
Enumeration date
01/28/2016
Last updated
01/28/2016
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