Individual
REGINA A MARES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
504 1ST ST, TULAROSA, NM 88352-2702
(575) 585-8800
Mailing address
504 1ST ST, TULAROSA, NM 88352-2702
(575) 585-8800
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SWB-2024-0855
NM
Other
Enumeration date
06/26/2015
Last updated
09/04/2024
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