Individual
MS. VERNA ANN KENNETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA, LSAA, CMS
Contact information
Practice address
NORTH 371 SOUTHWEST HIGHLAND DRIVE, CROWNPOINT, NM 87313
(505) 786-2111
(505) 786-5442
Mailing address
BOX 1144, SOUTHWEST HIGHLAND DRIVE, CROWNPOINT, NM 87313-1144
(505) 786-2111
(505) 786-5442
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
0138591
NM
171M00000X
Case Manager/Care Coordinator
Primary
0138591
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1831397488
BHS
NM
Enumeration date
04/18/2011
Last updated
04/18/2011
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