Individual
MS. REBECCA G JASPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW ACSW LISW
Contact information
Practice address
2901 E 20TH ST, SUITE 104, FARMINGTON, NM 87402-4411
(505) 326-0241
(505) 325-8356
Mailing address
PO BOX 3602, FARMINGTON, NM 87499-3062
(505) 326-0241
(505) 325-8356
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
I2737
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
F5718
—
NM
Enumeration date
10/17/2006
Last updated
06/07/2011
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