Individual
MRS. JESSIE G KAUFMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
235 PASEO DEL CANON E, TAOS, NM 87571-6239
(505) 613-3163
Mailing address
PO BOX 450, ARROYO HONDO, NM 87513-0450
(505) 776-3987
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-05995
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
27107761
—
NM
Enumeration date
10/16/2006
Last updated
06/01/2015
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