Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker | 57636 | TX |
Y | 104100000X | Social Worker | M-08336 | NM |
NPI | 1003207879 |
---|---|
Provider Name | Manuel Torres |
First Address | El Paso, TX 79930-4210 |
Second Address | Las Cruces, NM 88011-4550 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2015 |
Last Update Date | 13/02/2015 |