Healthcare Provider Details

I. General information

NPI: 1225059785
Provider Name (Legal Business Name): DEBORAH LEONE GEISLER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 06/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 E MESCALERO RD
ROSWELL NM
88201-6542
US

IV. Provider business mailing address

110 E MESCALERO RD
ROSWELL NM
88201-6542
US

V. Phone/Fax

Practice location:
  • Phone: 575-755-2272
  • Fax: 575-622-3325
Mailing address:
  • Phone: 575-755-2272
  • Fax: 575-622-3325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC-2660
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: