Individual
ANNIE BROTHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMSW
Contact information
Practice address
1911 5TH ST STE 100, SANTA FE, NM 87505-5403
(505) 955-0410
Mailing address
102 N CORONADO AVE, ESPANOLA, NM 87532-2700
(505) 692-4473
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
X-11723
—
NM
Enumeration date
10/09/2020
Last updated
10/09/2020
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