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Individual

MS. CAMILLE MATTHEWS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LISW BCD

Contact information

Practice address
904 E 20TH ST, STE B, FARMINGTON, NM 87401
(505) 325-6532
(505) 325-0827
Mailing address
904 E 20TH ST, STE B, FARMINGTON, NM 87401
(505) 325-6532
(505) 325-0827

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-4114
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00067835
NM
Enumeration date
11/27/2006
Last updated
07/08/2007
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