Individual
MR. BRAD K HOLMGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LISW
Contact information
Practice address
900 CENTRAL, BAYARD, NM 88023
(505) 537-4000
(505) 537-3358
Mailing address
226 N. CALIFORNIA AVE, SILVER CITY, NM 88061
(505) 388-0263
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I3761
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
R8449
—
NM
Enumeration date
03/02/2007
Last updated
07/08/2007
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