Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | X-08698 | NM |
NPI | 1003226507 |
---|---|
Provider Name | Kristine Jaramillo |
First Address | Moriarty, NM 87035 |
Second Address | Moriarty, NM 87035 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2014 |
Last Update Date | 07/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
M-09117 | LICENSED MASTERS SOCIAL WORKER (01) | NM |