Individual
MIAH SELENA EIDENSCHINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
224 W D. L. INGRAM AVENUE, BLDG. 1408, CANNON AFB, NM 88103-5014
(575) 904-3911
Mailing address
224 W D. L. INGRAM AVENUE, BLDG 1408, CANNON AFB, NM 88103-5014
(575) 904-3901
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
107873
TX
Other
Enumeration date
05/31/2022
Last updated
08/03/2025
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