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General NPI Number Information
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NPI Number | 1417798554
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Entity Type | Individual
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Provider Name | JESSICA ADKINS LMSW
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Gender | Female
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 910 N DATE ST
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City | TRUTH OR CONSEQUENCES
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State | NM
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Zip | 87901-1748
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Country | US
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Telephone | 575-894-8166
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1777
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City | ELEPHANT BUTTE
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State | NM
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Zip | 87935-1777
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Country | US
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Telephone | 575-740-1713
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Fax |
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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 | SWB-2023-0406
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License Number State | NM
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