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General NPI Number Information
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NPI Number | 1033120357
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Entity Type | Individual
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Provider Name | GINNETTE P WEINER LISW
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Gender | Female
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3885 FOOTHILLS RD STE B
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City | LAS CRUCES
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State | NM
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Zip | 88011-4672
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Country | US
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Telephone | 505-521-3388
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Fax | 505-521-4023
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Provider Business Mailing Address
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Address Line | 3885 FOOTHILLS RD STE B
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City | LAS CRUCES
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State | NM
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Zip | 88011-4672
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Country | US
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Telephone | 505-521-3388
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Fax | 505-521-4023
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | I-05935
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License Number State | NM
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