Individual
MS. JENNIFER LEIGH BONALUMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW, LADAC
Contact information
Practice address
100 W GRIGGS AVE, LAS CRUCES, NM 88001-1234
(575) 647-2800
(575) 647-2898
Mailing address
100 W GRIGGS AVE, LAS CRUCES, NM 88001-1234
(575) 647-2800
(575) 647-2898
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0138441
NM
104100000X
Social Worker
M-06691
NM
1041C0700X
Clinical Social Worker
Primary
X-08726
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18677037
—
NM
Enumeration date
10/05/2010
Last updated
02/10/2015
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