Individual
KIM GROOMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1600 SUTTER PL, CLOVIS, NM 88101-4611
(505) 769-4490
(505) 935-0011
Mailing address
2609 HAMMOND BLVD, CLOVIS, NM 88101-8632
(505) 742-3013
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
286795
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
45822891
—
NM
Enumeration date
11/08/2006
Last updated
07/08/2007
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