Individual
MS. TAMMY L. WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
2595 WEST HIGHWAY 66, GRANTS, NM 87020
(505) 285-5451
(505) 285-6436
Mailing address
2595 W. HIGHWAY 66, GRANTS, NM 87020
(505) 285-5451
(505) 285-6436
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
M-08319
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16351720
—
NM
Enumeration date
09/14/2009
Last updated
01/23/2014
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