Individual
MRS. MARY CATHERINE HEADPOWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 W BROADWAY, FARMINGTON, NM 87401-5638
(505) 324-5834
(505) 324-5896
Mailing address
1001 W BROADWAY SUITE D, FARMINGTON, NM 87401-5638
(505) 320-9592
(505) 327-5385
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
B-04808
NM
Other
Enumeration date
03/25/2016
Last updated
09/26/2017
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