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Individual

ANGELICA R. SEGURA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW

Contact information

Practice address
DE BACA FAMILY PRACTICE CLINIC, 546 N. 10TH STREET, FORT SUMNER, NM 88119
(575) 355-2414
(575) 355-7894
Mailing address
P.O. BOX 349, FORT SUMNER, NM 88119
(575) 355-2414
(575) 355-7894

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
07/30/2012
Last updated
10/17/2019
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