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General NPI Number Information
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NPI Number | 1679737019
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Entity Type | Individual
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Provider Name | SCOTT PAUL RHIEN L.I.S.W.
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Gender | Male
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Dates
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Enumeration Date | 07/15/2008
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Last Update Date | 07/15/2008
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Provider Practice Location Address
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Address Line | 925 CANNERY CT STE A
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City | FARMINGTON
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State | NM
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Zip | 87401-4058
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Country | US
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Telephone | 505-327-6123
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Fax |
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Provider Business Mailing Address
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Address Line | 4717 SUNDOWN RD
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City | FARMINGTON
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State | NM
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Zip | 87401-8610
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Country | US
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Telephone | 505-609-6461
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I-4055
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License Number State | NM
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