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Individual

TONY BOBADILLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW, PHD

Contact information

Practice address
505 S MAIN ST, STE 249, LAS CRUCES, NM 88001-1206
(575) 527-5884
(575) 527-5886
Mailing address
505 S MAIN ST, STE 249, LAS CRUCES, NM 88001-1206
(575) 527-5884
(575) 527-5886

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
M-08350
NM
1041C0700X
Clinical Social Worker
Primary
C-09780
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C-09780
NM REG & LICENSING DEPT
NM
Enumeration date
08/10/2013
Last updated
07/21/2022
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