Individual
MS. LISA J RUPARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.I.S.W., CHT
Contact information
Practice address
180 N DATE ST, TRUTH OR CONSEQUENCES, NM 87901-2824
(575) 894-8350
Mailing address
617 KRUGER ST, TRUTH OR CONSEQUENCES, NM 87901-2015
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-05321
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34228225
—
NM
Enumeration date
04/02/2007
Last updated
10/04/2013
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