Individual
TANYA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3 MORA VALLEY CLINIC RD, MORA, NM 87732-2202
(575) 387-2201
(575) 387-9149
Mailing address
3 MORA VALLEY CLINIC RD, MORA, NM 87732-2202
(575) 387-2201
(575) 387-9149
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
M-08343
NM
Other
Enumeration date
08/04/2014
Last updated
08/04/2014
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