Individual
MRS. KIMMBERLY VISCAINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LBSW, LPN
Contact information
Practice address
700 E. 3RD ST, PORTALES, NM 88130-6025
(575) 356-7045
(575) 359-0826
Mailing address
700 E. 3RD ST, PORTALES, NM 88130
(575) 356-7045
(575) 359-0826
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
B-11042
NM
Other
Enumeration date
02/28/2022
Last updated
02/28/2022
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