Individual
JUANA NEVAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
461 BLUE SAGE AVE SW, LOS LUNAS, NM 87031-6643
(505) 515-7980
Mailing address
461 BLUE SAGE AVE SW, LOS LUNAS, NM 87031-6643
(505) 515-7980
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
M-05683
NM
1041C0700X
Clinical Social Worker
Primary
C-09631
NM
1041S0200X
School Social Worker
C-09631
NM
1041S0200X
School Social Worker
M05683
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
58925333
—
NM
Enumeration date
01/08/2007
Last updated
06/27/2023
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