Individual
MR. DERYL W PALMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LISW
Contact information
Practice address
2000 E LOHMAN AVE STE C, LAS CRUCES, NM 88001-3100
(575) 523-2288
(575) 523-2299
Mailing address
PO BOX 6824, LAS CRUCES, NM 88006-6824
(575) 523-2288
(575) 523-2299
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-06859
NM
1041S0200X
School Social Worker
M05423
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
26782341
—
NM
Enumeration date
02/27/2007
Last updated
06/30/2011
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