Individual
VICKI FULLER ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
530 DE MOSS ST, HILDAGO MEDICAL SERVICES, LORDSBURG, NM 88045-2618
(575) 542-8384
(575) 542-8387
Mailing address
530 DE MOSS ST, LORDSBURG, NM 88045-2618
(575) 542-8384
(575) 542-8387
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I05940
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
49878531
—
NM
Enumeration date
07/18/2005
Last updated
03/04/2008
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