Individual
ELIZABETH C. TUDOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW C-06550
Contact information
Practice address
25 KINGSTON MAIN ST, HILLSBORO, NM 88042-9514
(575) 313-2385
Mailing address
25 KINGSTON MAIN ST, HILLSBORO, NM 88042-9514
(575) 313-2385
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C-06550
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
83726888
—
NM
Enumeration date
03/20/2007
Last updated
03/27/2020
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