Individual
MRS. VANESSA D. SIDRANSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
405 ARROW ST, LAS VEGAS, NM 87701
(505) 331-7264
Mailing address
406 ARROW ROAD, LAS VEGAS, NM 87701
(505) 331-7264
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-05975
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
314991
PED LICENSE
NM
05
—
61481076
—
NM
Enumeration date
11/02/2006
Last updated
05/28/2013
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