Individual
MRS. VIRGINIA MARIE HOLBROOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
1960 N DATE ST, TRUTH OR CONSEQUENCES, NM 87901-3701
(575) 894-7662
(575) 894-7930
Mailing address
PO BOX 370, HATCH, NM 87937
(575) 267-3280
(575) 267-1747
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
I-06764
NM
104100000X
Social Worker
M4321
NM
1041C0700X
Clinical Social Worker
Primary
I-06764
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
55771262
—
NM
Enumeration date
04/18/2006
Last updated
08/01/2011
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