Healthcare Provider Details

I. General information

NPI: 1326349036
Provider Name (Legal Business Name): PATRICIA E HAMAD LBSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/11/2010
Last Update Date: 11/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 EAST NINTH AVENUE SIERRA VISTA HOSPITAL COUNSELING CENTER
TRUTH OR CONSEQUENCES NM
87901
US

IV. Provider business mailing address

800 EAST NINTH AVENUE SIERRA VISTA HOSPITAL COUNSELING CENTER
TRUTH OR CONSEQUENCES NM
87901
US

V. Phone/Fax

Practice location:
  • Phone: 575-743-1380
  • Fax: 575-743-1362
Mailing address:
  • Phone: 575-743-1380
  • Fax: 575-743-1362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberB.07182
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: