Individual
MISTY DAWN PULSIPHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
6582 E MAIN ST, FARMINGTON, NM 87402-5122
(505) 947-9990
Mailing address
602 E 39TH ST, FARMINGTON, NM 87401-2308
(801) 678-9504
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
M-11563
NM
Other
Enumeration date
02/18/2021
Last updated
07/13/2022
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