Individual
ALLISON IACOCCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 E MARKET ST, SILVER CITY, NM 88061-5450
(828) 482-6344
Mailing address
PO BOX 405, CLIFF, NM 88028-0405
(575) 654-2919
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
X-11244
NM
Other
Enumeration date
12/13/2019
Last updated
12/13/2019
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