Individual
MS. KATHLEEN EISENBROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LISW
Contact information
Practice address
343 MAIN ST NW, LOS LUNAS, NM 87031-8712
(505) 866-2440
Mailing address
343 MAIN ST NW, LOS LUNAS, NM 87031-8712
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
I - 2882
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
K8717
—
NM
Enumeration date
01/08/2007
Last updated
07/09/2007
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