Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | I-07487 | NM |
NPI | 1003051053 |
---|---|
Provider Name | Cinda Louise Valentine |
First Address | Aztec, NM 87410-3107 |
Second Address | Aztec, NM 87410-3107 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2008 |
Last Update Date | 09/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04135237 | (05) | NM |
I-07457 | NEW MIXICO BOARD OF SOCIAL WORK EXAMINERS (01) | NM |
M-06855 | LMSW (01) | NM |