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Individual

MR. MALLET REID

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMSW

Contact information

Practice address
704 TALON CT NE, RIO RANCHO, NM 87144-4712
(575) 513-5383
Mailing address
704 TALON CT NE, RIO RANCHO, NM 87144-4712
(575) 513-5383

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
M-09673
NM

Other

Enumeration date
01/30/2017
Last updated
01/30/2017
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