Individual
ANTHONY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
114 N BEHREND AVE, FARMINGTON, NM 87401-8414
(505) 326-2736
(505) 325-2127
Mailing address
PO BOX 1709, FARMINGTON, NM 87499-1709
(505) 326-2736
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
M-06370
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
M1925
—
NM
Enumeration date
06/18/2009
Last updated
06/18/2009
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