Doctor Name: | MRS. VIRGINIA A ALLEN |
NPI Number: | 1003837568 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.I.S.W. |
License Number: | I-05743 |
Business Practice Address: | 101 N 2nd St Raton, NM - 877403803 |
Business Phone Number: | 5054457090 |
Business Fax Number: | 5054457663 |
Mailing Address: | 101 N 2nd St, RATON |
State: | NM |
Postal Code: | 877403803 |
Phone Number: | 5054457090 |
Fax Number: | 5054457663 |
NPI Enumeration Date: | 07/21/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041S0200X |
License Number: | I-05743 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | School |
Taxonomy Definition: |