Individual
MISS TAMMIE C KIDDY-KNIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
5 SIERRA VISTA DR, CEDAR CREST, NM 87008-9459
(505) 918-9991
Mailing address
5 SIERRA VIS, CEDAR CREST, NM 87008-9459
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
M-08943
NM
Other
Enumeration date
09/26/2012
Last updated
06/16/2015
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