Individual
THOMAS J KERLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LBSW
Contact information
Practice address
1000 E AZTEC AVE, GALLUP, NM 87301-5509
(505) 721-1872
Mailing address
1000 E AZTEC AVE, GALLUP, NM 87301-5509
(505) 721-1872
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
B-1192
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B-1192
—
NM
Enumeration date
09/04/2007
Last updated
09/04/2007
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