Individual
MIKO REANN BIRDSONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1725 IMPERIAL CT, CLOVIS, NM 88101-8633
(575) 219-2505
Mailing address
1725 IMPERIAL CT, CLOVIS, NM 88101-8633
(575) 219-2505
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
SWB-2022-1021
—
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3710730677
—
NM
Enumeration date
01/25/2023
Last updated
07/21/2025
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