Individual
MRS. JOELLE LIZETTE BRACKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
500 LASER RD NE, RIO RANCHO, NM 87124-4517
(505) 627-2562
Mailing address
1425 MONTIANO LOOP SE, RIO RANCHO, NM 87124-8769
(575) 910-8102
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SWB-2023-0806
NM
1041S0200X
School Social Worker
256905
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720103823.
—
NM
05
—
50423835
—
NM
Enumeration date
03/20/2007
Last updated
02/22/2024
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