Individual
KAITLYN MAE HALLWYLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LBSW
Contact information
Practice address
2884 N ROADRUNNER PKWY, LAS CRUCES, NM 88011-0853
(575) 556-6115
Mailing address
906 S MELENDRES ST, LAS CRUCES, NM 88005-2932
(313) 405-8915
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
X-11430
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
X-11430
PROVISIONAL BACCALAUREATE SOCIAL WORK LICENSURE
NM
Enumeration date
03/24/2020
Last updated
03/24/2020
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