Individual
MIMIR JOTTUN EVERETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Credential
MS, LCSW
Contact information
Practice address
901 RIO GRANDE BLVD NW STE G252, ALBUQUERQUE, NM 87104-2050
(505) 702-8112
Mailing address
901 RIO GRANDE BLVD NW STE G252, ALBUQUERQUE, NM 87104-2050
(505) 720-8112
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
26642
ND
1041C0700X
Clinical Social Worker
Primary
C-11784
NM
Other
Enumeration date
06/25/2021
Last updated
02/26/2025
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